Senior Hospital Contracting Strategist — Remote

CarePlus Health Plans, Inc.; Florida; Remote; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus incentive plan

Remote work

Travel as needed

Job summary

CarePlus Health Plans, Inc. seeks a Senior Hospital Contracting professional to initiate, negotiate, and execute physician, hospital and provider contracts for a Medicare Advantage focused organization.

You will report to the Director, Provider Contracting and lead negotiations with hospital systems across Florida. Ideal candidate has 5+ years of Medicare hospital negotiation experience, strong financial analysis skills, and a track record in value-based contracting.

Qualifications

• Bachelor's degree required.
• 5+ years hospital negotiation experience in Medicare.
• 5+ years progressive network management experience in healthcare contracting.
• Experience negotiating managed care contracts with hospital systems including post-acute, ancillary providers and physicians.
• Ability to analyze financial impact of contract terms and communicate to providers.
• Proficient in Microsoft Office.

Responsibilities

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

Skills

Contract negotiations

Hospital contracting

Medicare Advantage/Medicaid

Financial analysis

Provider relationship management

Leadership

Value-based contracting

Reimbursement methodologies

Communication to providers

Microsoft Office

Education

Bachelor's degree

5+ years hospital negotiation experience in Medicare

5+ years progressive network management experience

Experience negotiating managed care contracts with Hospital systems

Tools

Microsoft Office - Word, Excel, PowerPoint

Job description

CarePlus Health Plans, Inc. seeks a Senior Hospital Contracting professional to initiate, negotiate, and execute physician, hospital and provider contracts for a Medicare Advantage focused organization.

You will report to the Director, Provider Contracting and lead negotiations with hospital systems across Florida. Ideal candidate has 5+ years of Medicare hospital negotiation experience, strong financial analysis skills, and a track record in value-based contracting.