What are the responsibilities and job description for the Initial Budget Entry - Network Management & Contracting, Hospital Contract Manag position at MVP Health Care?
Initial Budget Entry - Network Management & Contracting, Hospital Contract Manager
Burlington Office, 62 Merchants Row, Williston, Vermont, United States of America Fishkill Office, 300 Westage Business Center Drive, Fishkill, New York, United States of America Headquarters Office, 625 State Street, Schenectady, New York, United States of America Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America Req #1591
Tuesday, July 18, 2023
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
This position works with Network leadership, team members, key leaders/contributors across the organization, as well as key leaders/contributors from outside MVP to develop, negotiate, implement, oversee, and evaluate hospital contracts for the region.
ESSENTIAL JOB FUNCTIONS:
Manage unit cost budgets, target setting, performance reporting and associated financial models.
Utilize transparency data to assist in development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management.
Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls.
Establishes and maintains strong business relationships with Hospital and Ancillary Facilities.
Responsible for the logistics of coordinating hospital and facility contract processing, contract language, contract updates, amendments, upcoming negotiations (by LOB), data requisitions, tracking, report outs and all related on-going contract business processes.
Coordinates the data on cost, utilization and other data trends to support the negotiation process. Uses Medicare, Medicaid and MVP proprietary reimbursement methodologies to analyze and assist with the negotiation and signing of new and renewed agreements in a manner needed to support MVP's premiums.
Negotiates and drafts individual contracts with hospitals and health systems. Prepares, analyzes, reviews and projects financial impact of large, complex contracts.
Ensures the smooth operation and administration of provider agreements.
Maintains an inventory of contracts, due dates, term clauses/end dates, spend and services by LOB. Requests necessary data analytics from Informatics to support key business objectives and product objectives where contracting is involved. Keeps and maintains necessary database trackers and a tracking system for department and MVP report outs. Processes forms, tracks and scans signed/executed agreements and amendments.
May train and mentor other contractors.
OTHER DUTIES & RESPONSIBILITIES:
Participates in meetings and supports successful implementation for assigned projects using good judgement and decision making.
Assists with developing budget and ensure department operates within approved budget.
Ability to maintain confidentiality and adhere to regulatory compliance issues as they exist and change from time to time.
Proactive in identifying areas for efficiency improvement across all of Network Management; consistently challenges the status quo in favor of incremental improvement opportunities that could be achieved through new methods.
Performs other related duties as assigned.
JOB QUALIFICATIONS:
Education/Degree:
Bachelors Degree preferred, equivalent experience may be substituted if the candidate can demonstrate significant relevant work experience.
Experience:
Skills:
Physical demands/Working conditions:
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
Burlington Office, 62 Merchants Row, Williston, Vermont, United States of America
Tuesday, July 18, 2023
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
This position works with Network leadership, team members, key leaders/contributors across the organization, as well as key leaders/contributors from outside MVP to develop, negotiate, implement, oversee, and evaluate hospital contracts for the region.
ESSENTIAL JOB FUNCTIONS:
OTHER DUTIES & RESPONSIBILITIES:
JOB QUALIFICATIONS:
Education/Degree:
Bachelors Degree preferred, equivalent experience may be substituted if the candidate can demonstrate significant relevant work experience.
Experience:
- Minimum of 5 years experience in health insurance
Skills:
- Knowledge of ICD-10, CPT-4, HCPCS coding preferred
- Strong proficiency in problem solving and analysis
- Demonstrated ability to interact with all levels of management
- Adaptability and flexibility in a changing environment required
- Ability to use Excel, Microsoft Office, Power Point
- Excellent presentation skills
- Excellent follow up skills
- Excellent verbal and written communication skills
Physical demands/Working conditions:
- Some in office presence required
- Travel required as needed
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
- Job Family Network Management & Development
- Pay Type Salary
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