Job Description
The Senior Contract Admin reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
Responsibilities:
- Evaluates general and specialty payor proposals in conjunction with Manager, Contracting/Transplant, Director, Managed Care, and the Financial Planning and Decision Support team.
- Ties in Long Range Financial Plan considerations as well as viability factors for service lines and potential expansion of programs.
- Interacts with key hospital areas, administrative and clinical, to provide Managed Care perspective and feedback on issues, impacts and concerns regarding insurance payors.
- Coordinates completion of RFIs, Center of Excellence proposals, credentialing packets and any other informational requirements received from payors.
- Develops and maintains productive relationships with managed care payors, specialty payors, brokers, employer groups and other parties that support hospital's strategic goals and objectives.
- Communicates status and progress of the contracting team to internal hospital departments including but not limited to Revenue Cycle, General Counsel, and Senior Management.
- Maintains productive and collegial relationships with internal areas.
- Responds to Contract Auditor/Billing and Follow Up concerns and issues with prompt turnaround and efficiency.
- Analyzes and evaluates local and national managed care issues and market trends; keeping up to date on local market share and demand.
- Measures overall contract performance using Financial and Revenue Cycle data
- Collaborates on contract implementation.
- EOE/AA
Qualifications
Required:
Preferred:
- Five or more years in healthcare, negotiation experience on behalf of hospital/health system or large national payor.
- Master's Degree in Healthcare, Business or like studies.
Additional Information
Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.
Benefits
We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.
