Ancillary Contract Administrator
Prisma Health
full-time
Posted on:
Location Type: Remote
Location: South Carolina • United States
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About the role
- Reviews, negotiates, and manages contracts for ancillary services including but not limited to Ambulatory Surgery Center, Urgent Care, imaging, and infusion.
- Requires strong financial, analytical, contract language knowledge, and negotiation skills to support the strategic business goals of the organization.
- Negotiates and maintains contracts including but not limited to all ancillary services required by all payer types in which Prisma Health participates.
- Contributes to the execution of strategic JV initiatives aligned with the organization’s goals.
- Conducts market and competitive data analysis to inform key decision-making and positioning strategies.
- Monitors and reports on key contractual financial performance indicators.
- Possesses a strong understanding of healthcare, contract law, and market factors to ensure network compliance, cost savings, and high-quality patient care within specified time frames in collaboration with key stakeholders.
- Performs detailed analyses of the financial and operational impact of procedural changes implemented by payers.
- Creates and implements educational presentations for changes being implemented by Payor for organizational departments.
- Collaborates with and trains department team members in assisting with managing the processing of all ancillary payer contracts and amendments including language, reimbursement methodology review, and contracting.
- Conducts proactive communication, contract compliance, and educational sessions.
- Develops and maintains effective relationships with payers and internal customers.
- Performs other duties as assigned.
Requirements
- Education - Bachelor's degree in Business or a related field.
- Masters degree in Finance, or Business preferred.
- Five (5) years of related experience.
- 5 years Ancillary Contracting experience in a contracting or provider relations role preferred.
- In Lieu Of In lieu of the education and experience requirements noted above, the following combination of education, training and/or experience may be considered an equivalent substitution: Bachelor's Degree and eight (8) years Managed Care Systems experience in healthcare administration, health insurance, provider contracting, or a related field.
- Knowledge of the health-insurance industry, specifically managed-care contracting operations and negotiation techniques.
- Knowledge of office equipment (fax/copier).
- Proficient computer skills (word processing, spreadsheets, database).
- Mathematical skills.
- Understanding/experience in healthcare/nursing industry, preferably in training and implementation of contract management systems preferred.
Benefits
- Inspire health.
- Serve with compassion.
- Be the difference.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract negotiationfinancial analysiscontract managementdata analysisreimbursement methodologycontract complianceeducational presentation developmentancillary contractingmanaged care systemshealthcare administration
Soft Skills
communicationcollaborationrelationship managementanalytical thinkingstrategic thinkingtrainingproblem-solvingorganizational skillsnegotiation skillsproactive communication