Remote Hospital Contracting Leader — Value-Based Care

CarePlus Health Plans; Maryland; On-site; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus eligible

Job summary

CarePlus Health Plans is seeking a Senior Hospital Contracting Strategist to lead negotiations and execution of provider contracts, including hospital, physician, and others. You will report to the Director, Provider Contracting and help shape network strategy.

The role requires 5+ years in hospital contracting, expertise in reimbursement methodologies, and strong financial analysis skills. Remote work with periodic travel, 40-hour weeks, and bonus opportunities are included.

Qualifications

• Bachelor's degree attained.
• 5+ years of hospital negotiation experience in Medicare.
• Leading negotiations for hospital and health system agreements, including reimbursement, terms, amendments, renewals, and value based agreements.
• 5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company.
• Experience negotiating managed care contracts with hospital systems including post-acute and physicians.
• Ability to analyze and communicate financial impact of contract terms and reimbursement.
• Ability to interpret hospital contract language.
• Proficiency with Word, Excel and PowerPoint.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements.
• Demonstrate expertise in hospital contracting, reimbursement methodologies and financial analysis.
• Collaborate with Finance, Legal, Network Management, Claims and Operations to ensure contracts are financially sound and operationally executable.
• Communicate contract terms and payment structures to providers.
• Maintain contracts and documentation in a tracking system.
• Identify and recruit providers based on network needs.

Skills

Hospital contracting

Negotiations

Reimbursement methodologies

Value based contracting

Provider relationship management

Financial analysis

Medicare Advantage

Medicaid

Leadership

Microsoft Office

Education

Bachelor's degree

Tools

Microsoft Office

Job description

CarePlus Health Plans is seeking a Senior Hospital Contracting Strategist to lead negotiations and execution of provider contracts, including hospital, physician, and others. You will report to the Director, Provider Contracting and help shape network strategy.

The role requires 5+ years in hospital contracting, expertise in reimbursement methodologies, and strong financial analysis skills. Remote work with periodic travel, 40-hour weeks, and bonus opportunities are included.