Contracting Specialist II

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SAMARITANHEALTHSERVICES
Req #: 50770
Corvallis, OR
1.0 (80 hrs/pp) - Day
SHS Health Plan Ops - Strategy
Remote Status: No
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  • JOB SUMMARY/PURPOSE
    • Leads, develops and maintains strong, positive relationships with assigned standard and complex provider accounts, including assurance of provider satisfaction with Samaritan Health Plans. Proactively manages assigned provider accounts to achieve Samaritan Health Plans strategies and goals for product and provider contract development.
  • DEPARTMENT DESCRIPTION
    • Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Bachelor's degree in a healthcare or business related field, or equivalent experience required.
    • Four (4) years experience managing provider relationships and provider contract negotiations required.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Excellent written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Excellent public relations and interpersonal skills. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
    • Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
    • Self-starter and the ability to lead with minimal direction. Proven ability to lead and mentor small teams. Strong organizational, planning and administrative skills.
    • Ability to draft contract language to meet legal criteria and familiarity with provisions in health insurance. Ability to develop and execute strategy.
    • A thorough understanding of Samaritan Health Plans products. Understanding of complex financial arrangements and quality programs across health care products. Knowledge of different forms of reimbursement including capitation and their ramifications on providers as well as insurers. Knowledge of regulatory issues and network development.
    • Strong expertise in the provider environment.
    • Knowledge of provider profiling software, systems, and provider data utilization. Strong data management skills.
  • PHYSICAL DEMANDS
    • Rarely
      (1 - 10% of the time)

      Occasionally
      (11 - 33% of the time)

      Frequently
      (34 - 66% of the time)

      Continually
      (67 – 100% of the time)

      CLIMB - STAIRS

      LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs

      LIFT (Knee to chest: 24"-54") 0 – 20 Lbs

      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

      CARRY 1-handed, 0 - 20 pounds

      BEND FORWARD at waist

      KNEEL (on knees)

      STAND

      WALK – LEVEL SURFACE

      ROTATE TRUNK Standing

      REACH - Upward

      PUSH (0 - 20 pounds force)

      PULL (0 - 20 pounds force)

      SIT

      CARRY 2-handed, 0 - 20 pounds

      ROTATE TRUNK Sitting

      REACH - Forward

      MANUAL DEXTERITY Hands/wrists

      FINGER DEXTERITY

      PINCH Fingers

      GRASP Hand/Fist

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