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Job description
Responsibilities
I. JOB SUMMARY/RESPONSIBILITIES:
• Assists in development, maintenance and administration of the medical centers' contracts with health insurers for services provided to members.
• Performs financial analysis, operational evaluation, and compliance issues on payer agreements to recommend action for executive review.
• Makes recommendations for optimal member utilization and objective financial criteria.
• Functions as a member of the contracting team to negotiate optimal contractual agreements.
• Responsible for maintenance of contract modules.
• Serves as a liaison with selected payers to promote the service of the medical center and improve provider relations with third party payers.
II. TYPICAL PHYSICAL DEMANDS:
• Essential/continuous: Sitting, finger dexterity seeing, hearing, speaking, repetitive arm/hand motions, static gripping of an object for prolonged periods, frequent gripping of an object.
• Operates computer, typewriter, calculator, telephone, fax and printer.
III. TYPICAL WORKING CONDITIONS:
• Not substantially subjected to adverse environmental conditions.
IV. MINIMUM QUALIFICATIONS:
A. EDUCATION/CERTIFICATION AND LICENSURE:
• Bachelor's degree in Business, Finance or Health Care Administration or four (4) years with health care provider or payer in contracting or business operations.
• Master's degree in related field preferred.
• Knowledge of healthcare delivery systems, including contracting and financial analysis.
• Knowledge of current regulatory billing and collection policies and procedures.
• Knowledge of computer assisted analytical tools including word processing, spreadsheet, and software for hospital contract and/or claims management.
B. EXPERIENCE:
• In additional to the educational requirement, two (2) years experience with a health care provider or payer in contracting or business operations.
• Demonstrated ability to work independently and effectively with internal and external personnel at various levels of responsibility.
Equal Employment Opportunity
Equal Opportunity Employer / Disability / Vet
Worksite address
aiea, HI, 96701, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.