To develop, maintain, implement and monitor contractual relationships with third party Insurance Payors on behalf of HFHS and its business units.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

1. Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate contractual provisions and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units.

2. Independently evaluate and analyze contract proposals including completing initial proposal responses and reviewing/revising contract language and operational requirements. Reviews contracts with in house legal-council and works through contract revisions with Payors.

3. Routinely monitor current contracts for appropriate rate structure, contract terms and annual renewals and/or re-negotiations and compliance with industry standards and guidelines.

4. Monitor marketplace for new contracting opportunities and make recommendations of changes to enhance HFHS contract portfolio.

5. Coordinate implementation of Payor arrangements and provide ongoing education and support throughout HFHS.

6. Collect and communicate relevant contractual requirements and issues to internal customers such as Utilization Management, Finance, Patient Billing, Administration, Legal, etc. Information includes; payor relationships, operational requirements and contract terms.

7. Maintain comprehensive files of HFHS contractual relationships and update contract information in the contract database.

8. Maintain contract summaries on HFHS website (Henry).

9. Act as liaison between HFHS and Payors on contracting and operational issues, i.e. billing, utilization review, credentialing site visits, notification of site closures or new services.

10.Coordinate facility credentialing and re-credentialing.

11.Perform other duties as assigned.

EDUCATION/EXPERIENCE REQUIRED:

• Bachelors Degree in Business, Healthcare or related field.

• Minimum of four (4) years in the healthcare industry in a professional capacity.

• Knowledge of managed care organizations and integrated health systems.

• Previous contracting, provider relations and/or provider reimbursement experience.

• Comprehensive project management abilities.

• Excellent oral and written communication and presentation skills.

• Excellent organizational skills and ability to manage multiple projects simultaneously.

• Excellent interpersonal skills and ability to develop effective working relationship with both internal and external customers.

• Strong negotiation skills.

• Understanding of legal, business, and insurance operations principles. Proficient in Microsoft Word.

PHYSICAL DEMANDS/WORKING CONDITIONS:

• Normal office environment with minimal exposure to noise, dust, or extreme temperatures.

Additional Information

• Organization: Corporate Services

• Department: Managed Care Contracting

• Shift: Day Job

• Union Code: Not Applicable

  Additional Details

  This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Partnering with nearly 2 million people on their health journey, Henry Ford Health provides a full continuum of services at 250 care locations throughout southeast and south central Michigan. With 33,000 valued team members, Henry Ford is also among Michigan’s largest and most diverse employers. Our superior care and discoveries are powered by nearly 6,000 physicians, researchers and advanced practice providers. Learn more athenryford.com.

Benefits

Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.