Insurance Contract Administrator - Full Time- Remote/Hybrid
72% Flex- Remote from:United States
Insurance Contract Administrator - Full Time- Remote/Hybrid
Job description
Your missions
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 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
Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a
$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites
including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and
other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system
now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one
of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the
health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s
major academic medical centers, receiving between $90-$100 million in annual research funding and
remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical
education and training, the health system has trained nearly 40% of physicians currently practicing
in the state and also provides education and training for other health professionals including nurses,
pharmacists, radiology and respiratory technicians. visit HenryFord.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.
Required profile
Experience
Hard Skills
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