Moda Health. Healthcare from your head to your toes.
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Sr Contract Negotiator
- Job Title
- Sr Contract Negotiator
- Duration
- Open Until Filled
- Work Hybrid
- Yes
- Description
-
Let’s do great things, together
About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
Position Summary
The Sr Contract Negotiator negotiates contracts with physicians, hospitals, complementary care providers and ancillary providers. Evaluates and negotiates contracts in compliance with Moda contract templates and reimbursement structure standards. Responsibilities also include establishing and maintaining strong business relationships with Hospital, Physician, Pharmacy, or Ancillary providers, and ensuring the network composition includes an appropriate distribution of provider specialties. This is a full-time hybrid position based in Portland, Oregon.
Pay Range
$70,579.27- $105,868.90 annually, DOE.
*Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
Please fill out an application on our company page, linked below, to be considered for this position- https://j.brt.mv/jb.do?reqGK=27746782&refresh=true
Benefits:- Medical, Dental, Vision, Pharmacy, Life, & Disability
- 401K- Matching
- FSA
- Employee Assistance Program
- PTO and Company Paid Holidays
Required Skills, Experience, & Education:- Demonstrated experience in contract negotiation, including provider, facility, physicians and ancillary
- Strong knowledge of provider reimbursement mechanisms, including Medicare and Medicaid fee schedules, case rates, per diems, and risk models.
- Strong verbal, written and interpersonal communication skills
- Strong financial analysis skills
- Ability to interpret and analyze complex information
- Strong decision-making abilities
- Proficiency in MS Office Products (Excel, Word, Power Point)
- Ability to work independently with minimal guidance
- Accuracy and detail orientation are required with ability to meet deadlines and prioritize workload
- Ability to work well under pressure: work with frequent interruptions and shifting priorities
- Ability to travel within the Moda service area
- Ability to represent Moda at outside meetings, conferences, and events
- Strong presentation skills
- Maintain confidentiality
Primary Functions:- Performs contract negotiations for assigned providers to ensure Moda’s medical provider networks achieve objectives for unit cost performance, access, and quality
- Coordinates financial analysis with Analytics and Underwriting teams, including developing provider reimbursement strategies to achieve business objectives
- Recruits new providers to join Moda networks, based on network goals and objectives
- Responsible for understanding and managing medical cost issues and initiating appropriate action
- Acts as a liaison for internal projects and committees
- Establishes and maintains business relationships with assigned providers and works as lead in a team environment to solve complex provider issues.
- Performs other duties as assigned.
Working Conditions & Contact with Others- Telephone and close keyboard work. Travel throughout state and/or designated territories (20-30%). Pre and post office hour meetings. Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need.
- Internally with many departments. Externally with Contracts Managers, CEOs and CFOs of IPA’s and Hospitals, Clinic Administrators, Business Office Managers, Provider Reimbursement Staff, and Physicians.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.
For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.
Option 2: Create a New Profile
Should you need an accommodation in applying to any of our open positions, please contact Human Resources at hradmin@modahealth.com or 503-228-6554.
