Remote Senior Hospital Contracting Strategist

CarePlus Health Plans; Virginia (IL); On-site; USD 78,000 - 108,000; Full time

Job summary

CarePlus Health Plans is seeking a Senior Hospital Contracting Strategist to lead and execute physician, hospital, and provider contracts. You will report to the Director, Provider Contracting and drive complex negotiations, including value-based arrangements.

The role requires extensive hospital contracting experience, cross-functional collaboration with Finance, Legal and Operations, and a focus on Medicare/Medicaid contracts.

Qualifications

• Bachelor's degree required.
• 5+ years hospital negotiation experience in Medicare.
• 5+ years progressive network management experience in a healthcare company.
• Experience negotiating managed care contracts with hospital systems including post-acute and physicians.
• Analyze financial impact of contract terms and reimbursement rates.

Responsibilities

• Lead negotiations for hospital and health system contracts, including reimbursement, contract terms, amendments, renewals, and value based agreements.
• Partner with Finance, Legal, Network Management, Claims, and Operations to ensure contracts are financially sound and operationally executable.
• Communicate contract terms, payment structures, and reimbursement rates to providers.
• Maintain contracts and documentation within a tracking system.
• Help identify and recruit providers based on network needs.

Skills

Hospital negotiations

Contract negotiations

Provider relations

Financial analysis

Medicare/Medicaid experience

Education

Bachelor's degree

Tools

MS Office

Job description

CarePlus Health Plans is seeking a Senior Hospital Contracting Strategist to lead and execute physician, hospital, and provider contracts. You will report to the Director, Provider Contracting and drive complex negotiations, including value-based arrangements.

The role requires extensive hospital contracting experience, cross-functional collaboration with Finance, Legal and Operations, and a focus on Medicare/Medicaid contracts.