At Saint Alphonsus Health System, we are looking for people who are living out their calling. We want you to be passionate about coming to work, and challenged to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care.
Network Contract Specialist
Saint Alphonsus Health System Boise, Idaho
Responsible for negotiating hospital, clinic and network managed care and direct payer contracts for Saint Alphonsus Health System (SAHS) and Saint Alphonsus Health Alliance (SAHA). Coordinates provider contracting functions for SAHA. Responsible for developing strong relationships with provider practices, internal teams, employers, brokers and payers.
Meets Health System's Guiding Behaviors and Caring Standards including interpersonal communication and professional conduct expectations.
Establishes relationships with key personnel at provider and payer offices.
Develops or evaluates contract proposals and provide comprehensive analysis and recommendations to leadership.
Evaluates payor contracts including reimbursement and risk provisions.
Develops and implements a contract modeling analysis of the financial terms of proposed contract.
Coordinates and participates in contract negotiations and renewals.
Maintains contract management software.
Stays abreast of legislative activities relevant to healthcare services, healthcare benefit plans and provider networks.
Supports SAHS hospital leadership in contract evaluation and negotiations.
Responsible for provider contracting activities and communications to include, provider notices, contract updates, and issue resolution.
Maintains professional fee schedules.
Assists in employee health plan network management.
Develops open enrollment and ongoing education regarding network/network changes (employee health plan).
Provides education regarding Alliance to potential network providers/practices.
Bachelor's degree required, preferably in Business Administration with a strong background in healthcare administration. 8 years of experience may be considered in lieu of degree.
Minimum of 5 years of experience in a healthcare setting preferably in payor/insurer contracting and/or provider contracting, and/or provider network support and development and practice management/administration required.
Experience in payor contract language review and contract modeling required.
Ability to work collaboratively with internal and external teams.
Excellent analytical, presentation, and interpersonal skills.
Intermediate computer skills with experience in MS Word, Excel, Access, PowerPoint, Outlook.
Apply online at our Careers Site: https://www.saintalphonsus.org/careers
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