Banner Health

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County.. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.. Negotiate and manage multiple complex payer fee for service and value-based contracts with insurance companies on behalf of Banner Health, all lines of business (e.g., hospitals, transplants, behavioral health, ancillaries, physician groups), and Banner Health Network.. Extensive knowledge of fee-for-service and value-based contract reimbursement for the purpose of protecting Banner Health and the Insurance Division legally and financially.. Must have a strong knowledge of healthcare industry financial indicators and an in depth understanding of Commercial, AHCCCS and CMS reimbursement methodologies.

contracts consultant

Primary City/State: Arizona, Arizona Department Name: Managed Care-Operations Work Shift: Day Job Category: General Operations Great careers are built at Banner. We understand that talented professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices including remote & hybrid work options. Apply today. Recognized nationally as an innovative leader in health care, Banner Plans & Networks (BPN) integrates Medicare and private health plans to reduce healthcare costs while keeping our members in optimal health. Known for our innovative, collaborative, and team-oriented approach, BPN offers a variety of career opportunities and innovative employment options by offering remote and hybrid work settings. As a Senior Managed Care Contract Consultant with Banner Plans & Networks, you will utilize your experience in leading contract negotiations, on behalf of the organization, for all Banner states. You will interact and present to Senior and Executive leadership inside and outside of Banner Health. You will write and manage multiple contracts. You will also manage highly detailed projects on an as needed basis. Your work location will be entirely remote. Your work schedule will vary depending on ongoing contract negotiations. If this sounds like the role for you, Apply today! Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs. Position Summary This position leads negotiations for managed care payer contracts on behalf of the organization. This position participates in the development and implementation of contract management tools and processes to assist in achieving the organizations contracting objectives and strategies. This position mentors, leads and trains Managed Care Contracts Consultants. This position manages the relationship between Service Line leaders, Service Line staff, and Managed Care. This position co-leads assigned special projects. Core Functions <ul><li> Negotiate and manage multiple complex payer fee for service and value-based contracts with insurance companies on behalf of Banner Health, all lines of business (e.g., hospitals, transplants, behavioral health, ancillaries, physician groups), and Banner Health Network. Assess business terms to be sure the contract supports the company/business unit goals. </li><li> Conduct analyses and compiles information for review of strategic contract terms for management review and decision making to specified areas of concern. Participates in contract monitoring and support tools (matrices), by reviewing and interpreting contracts, extracting key information for use by internal and/or external customers, and keeping abreast of changes in company locations for inclusion in various matrices. </li><li> Build and maintain relationships by collaborating with internal departments to successfully meet department and system strategic initiatives. </li><li> Extensive knowledge of fee-for-service and value-based contract reimbursement for the purpose of protecting Banner Health and the Insurance Division legally and financially. </li><li> Subject matter expert and Managed Care lead for joint ventures, acquisitions, new facility/ancillary openings, and special projects. Responsible for providing current information to colleagues for the purpose of document execution and payer communication. </li><li> Build relationships that cultivate health plan partnerships. Serve as a resource for internal and external clients to interpret contract language and resolve contract issues by reviewing and interpreting contract terms and originating contract documentation. Assist in resolving elevated and complex payer concerns. Research problems and negotiate with internal/external partners/customers to resolve escalated issues. </li><li> Provide leadership and training to Managed Care Contracts Consultants, including but not limited to reviewing and editing contract language in various documents, training new staff on essential department processes/communication flows, and serving as the primary resource for questions on complex and/or sensitive agreements. Responsible for mentorship and development of Managed Care Contracts Consultants, including intradepartmental introductions and relationship building. </li><li> Addresses challenges and obstacles with a positive solution-oriented mindset. </li></ul>Minimum Qualifications Experience consistent with a bachelor’s degree in business, healthcare or related field required. Requires seven years of contract negotiation experience. Must possess demonstrated skill in problem analysis and resolution; contract management; oral and written communication. Requires problem solving skills and complex decision-making skills. Requires highly developed interpersonal and listening skills. Must be detail oriented. Must be able to function independently, possess demonstrated flexibility in multiple project management. Experience in negotiating and administering health care insurance government and commercial payer contracts. Possess the interpersonal skills to interact effectively and cultivate supportive relationships with internal customers, managed care payors, consultants, outside agencies, and internal/external corporate executives. Ability to manage and lead all contractual aspects of major projects. Excellent written, proofreading, and verbal communication skills. Requires strong computer skills. Must have a strong knowledge of healthcare industry financial indicators and an in depth understanding of Commercial, AHCCCS and CMS reimbursement methodologies. Assignments in Managed Care require strong contract writing skills as well as a general understanding of health care claims. Preferred Qualifications For assignments in Managed Care, specific managed care contract experience is highly preferred. Additional Related Education And/or Experience Preferred. EOE/Female/Minority/Disability/Veterans Our organization supports a drug-free work environment. Privacy Policy

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