What are the responsibilities and job description for the Contract Representative II position at Moda Health?
Let’s do great things, together
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.
Moda Health is seeking a Contractor Representative. The Contract Representative II will be responsible for preparing, reviewing, and revising contracts, use analytical tools and strong communication skills in negotiating challenging contract renewals, enter contracts into our contract management database, and contributing to corporate projects. Cultivate and maintain professional relationships with providers and practices in assigned portfolios.
Primary Functions:
- Develops a contracting approach and specialized expertise required to contract with new types of provider entities which can occur when entering a new ongoing contractual relationship or when negotiating Single Case Agreements.
- Supports the implementation of Value-Based contracting models (VBC), capitation, Advanced Payment Models (APMs), and other population health initiatives.
- Develops strategic relationships with key providers, negotiating annual rate increases within set parameters and guidelines within an assigned portfolio, and providing recommendations to leadership on the renewal.
- Handles complex contracts using problem-solving skills to meet budget constraints, develops a rapport with provider groups and/or hospitals as well as works with the Provider Analytics and Contract Pricing teams on solving complex rate methodologies within assigned portfolio.
- Assists in the periodic assessment of Moda’s network status and recommends strategies when new trends are identified.
- Conducts strategy development based on network analysis results.
- Assists in the new implementation and ongoing modification of Moda’s statewide, regional, and local network strategies.
- Utilizes best practice policies and procedures, work guides, or tools to provide improved department process workflows.
- Coordinates and participate in targeted provider meetings, including annual Provider Workshops, with Provider Relations Representatives in assigned portfolio.
- Represents Moda at meetings and events at which contracted Moda hospitals and key Moda providers will be attending.
- Provides ongoing support to team members.
- Performs other duties as assigned.
- Bachelor’s degree in Business, Finance, Health Care Administration, or 2 years’ equivalent work experience in a related field.
- Minimum 3 years of experience negotiating contracts, specifically with ancillaries, facilities, specialty providers, and physician groups.
- Demonstrated strong interpersonal communication skills, including strong business writing skills in a manner that promotes goodwill, is timely, efficient, and accurate.
- Possess strong analytical, attention to detail, and problem-solving skills.
- Understanding of physician, hospital, and other provider contracts and reimbursement mechanisms.
- Ability to work with internal stakeholder departments to create a seamless and positive experience for the provider.
- Strong judgment and decision-making skills with ability to develop and foster strong working relationships.
- Strong PC proficiency with Microsoft Office applications.
- Ability to maintain confidentiality and project a professional business presence and appearance.
- Ability to work well under pressure as well as with frequent interruptions and shifting priorities. Ability to function effectively in a complex, ambiguous, demanding, and rapidly changing environment.
- Ability to come in to work on time and daily, working the hours required to support the team and meet all goals and objectives.
Are you ready to be a betterist?
If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.
Together, we can be more. We can be better.
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.
