Virginia MGMA Career Center

Contact the VMGMA Office at [email protected] if you would like to post a management position.

(6/03/22) Contract Negotiator (MedCost)

Position Summary (Careers | MedCost)
The Contract Negotiator, Network Management is responsible for the negotiation and recruitment, in assigned geographic areas, of Hospitals, Ancillary Providers, Ambulatory Surgery Centers, Physician Organizations, Physician Practices, University or Hospital based Faculty and Affiliated Physicians, and maintenance and enhancement of current relationships to accomplish network management goals of a comprehensive network with maximum savings for our clients. The person must live in VA and can work remotely. 
Position Responsibilities
• Responsible for hospital and provider accounts as assigned which include maintaining strong
     relationships, 
engaging providers as needed in new MedCost initiatives, negotiating contract
     terms and language that 
position MedCost for success and provide maximum savings for clients.
• Responsible for presentations to key decision makers within hospital and provider organizations
     to sell 
MedCost’s value proposition and encourage participation in new initiatives.
• Manipulate and analyze data with proficiency in order to create compensation proposals for physician
    practices, ancillary providers, hospitals, etc.
• Interact with the Reimbursement Project and Data Analyst and/or Network Reimbursement Data
    Analyst 
to provide data for successful negotiations with provider organizations, physician practices,
   hospitals, etc.

• Consult with Manager, Provider Contracting, on language and compensation terms including full
    review of 
hospital/provider business plans before presenting to contracting providers.
• Maintain momentum of negotiations leading up to execution of final agreements.
• Maintain accurate files, both paper and system, for all negotiation and recruit efforts and normal
    maintenance of existing agreements.
• Ensure that proper documentation is included with new contracts, certifications, licensure, liability
    insurance, a
ny additional facility information, and physician credentialing information.
• Coordinate the addition of ancillary facilities, hospital-based services, or physicians, employed
     physicians, 
or the billing of independent physicians, to the main hospital, facility, or Provider
     organization agreement.

• Initiate annual contract renewal evaluations and enter renegotiations, if necessary, to achieve
     competitive and 
marketable cost savings.
• Generate and submit monthly progress reports to Manager, Provider Networks with recruitment efforts
     completed or in progress, negotiations that are due or completed, and meetings attended.
• Interact effectively with other MedCost departments for the smooth flow of information to achieve
      Network 
Management goals.
• Respond to Customer Service or Marketing inquiries in a timely fashion to maintain superior customer
     service 
and provider satisfaction.
• Within the assigned geographic area, the Network Contract Negotiator, will keep abreast of new
     developments 
in health care delivery systems, key payer relationships, and market forces and
     issues and report pertinent 
information to upper management.
• Other duties as assigned.
Position Qualifications
Requirements
• High school diploma or equivalent required; minimum of 3 years provider contracting experience
     required.

Preferred
• A college degree is desirable, but not necessary, if a sufficient mix of education and experience enable
    the employee to perform job duties successfully.

Skills, Knowledge and Abilities
• Working knowledge of the health care delivery system and the managed care environment.
• Strong knowledge of complex hospital contracting methodology to include Medicare reimbursement
     methodologies such as RBRVS, DRGs, ASC groupers, etc.
• Value-based contracting experience a plus.
• Excellent communication skills, verbal and written. Ability to convey detailed technical information in
     individual and group settings.
• Excellent PC skills with experience with Windows, Word, and Excel programs.
• Ability to work with other MedCost departments in an effective and congenial manner.
• Ability to maintain a demanding schedule in a cost and time efficient manner.
• Ability to travel as needed (expect at least 30% of time outside of office) for recruitment and network
    maintenance needs.
• Willingness to work cooperatively and creatively to offer a high level of customer service to both
     providers 
and clients.

MedCost provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
MedCost participates in the Electronic Verification system (E-Verify) to electronically verify the work authorization of newly-hired employees. E-Verify is an internet-based program that compares information from an employee's Form I-9 to data contained in the federal records of the Social Security Administration and the Department of Homeland Security to confirm employment eligibility. MedCost does not use E-Verify to pre-screen job applicants.

 

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