Senior Hospital Contracting Leader - Remote

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

Benefits offered by this job

Bonus incentive plan

Job summary

CarePlus Health Plans seeks a Senior Hospital Contracting Strategist to initiate, negotiate, and execute provider contracts for a health insurance organization. You will report to the Director, Provider Contracting and drive complex hospital and payer negotiations.

The role demands extensive managed care experience, Medicare Advantage/Medicaid knowledge, and strong financial analysis to ensure favorable terms and sound contracts across networks—remote with travel possible.

Qualifications

• Bachelor's degree required.
• 5+ years hospital negotiation experience in Medicare.
• Experience leading hospital/health system contract negotiations.
• 5+ years progressive network management experience incl. hospital contracting.
• Experience negotiating managed care contracts with hospital systems.
• Ability to analyze financial impact of contract terms and reimbursement rates.
• Understand and interpret hospital contract language.
• Proficient in Word, Excel and PowerPoint.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements.
• Partner with Finance, Medical Economics, 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.
• Analyze financial impact of contracts and terms.
• Maintain contracts and documentation within a tracking system.
• Help with identifying and recruiting providers based on network needs.

Skills

Negotiation

Financial analysis

Provider contracts

Microsoft Office

Education

Bachelor's degree

Master's Degree

Tools

Microsoft Office

Job description

CarePlus Health Plans seeks a Senior Hospital Contracting Strategist to initiate, negotiate, and execute provider contracts for a health insurance organization. You will report to the Director, Provider Contracting and drive complex hospital and payer negotiations.

The role demands extensive managed care experience, Medicare Advantage/Medicaid knowledge, and strong financial analysis to ensure favorable terms and sound contracts across networks—remote with travel possible.