RMH Reynolds Memorial Hospital
Contract Specialist (HYBRID)
6 days agoWhat's your preference?
Job Description
- Req#: JR26-28039
Employer Industry: Healthcare Management
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Engaging in meaningful work that impacts healthcare payment methodologies
- Collaborative environment with various healthcare providers and insurance companies
- Involvement in critical contract negotiations and financial analyses
- Supportive employer committed to equal opportunity and diversity
What to Expect (Job Responsibilities):
- Conduct payer discussions and direct contract negotiations with insurance companies and HMOs
- Analyze and communicate hospital contracting and payment methodologies with financial and operational staff
- Facilitate discussions with insurance companies to resolve payment issues and discrepancies
- Perform contract compliance tests through claims extracts and payer payment evaluations
- Maintain contract files and organize meeting materials for various organizational meetings
What is Required (Qualifications):
- Bachelor’s degree in Health Care Management or a High School Diploma with two (2) years of contractual or financial-related experience
- Four years of experience in data analysis or business management, or two years in healthcare data analytics or contracting analytics
- Understanding of provider and payer contract issues
- Knowledge of roles of IPAs/PHOs in contracting and related antitrust issues
- Ability to maintain technical skills for data manipulation and report writing
How to Stand Out (Preferred Qualifications):
- Master’s degree
- Direct experience in healthcare payment methodology for physicians and hospitals
- Familiarity with major West Virginia provider organizations and their dynamics
#HealthcareManagement #ContractNegotiation #DataAnalysis #CareerGrowth #EqualOpportunityEmployer
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