Managed Care Contract Negotiator

DESCRIPTION of Contract Negotiator Role at TriHealth Job Overview: The Managed Care Contract Negotiator is a crucial member of the Managed Care team. An experienced and knowledgeable negotiator of Managed Care contracts and contractual interpretations for healthcare payment and benefit issues, this role requires the ability to draft and negotiate Managed Care contracts incorporating knowledge from health system care operations and administrative and financial areas. Key Responsibilities: Serves as a first line Managed Care Contract Negotiator for health system, responsible for assigned Managed Care contracts, payors, and payor types. Evaluates, negotiates, and secures financially and administratively favorable contracts with new and existing payors. Assists with all aspects of Managed Care operations including contract negotiation, request and review of contract payment modeling, and contract implementation. Communicates effectively at all organizational levels and must be able to prioritize, plan, and handle multiple tasks/demands simultaneously. Acts as a liaison between health system and other internal and external entities to create seamless operational Managed Care performance along with maximizing payor contracting terms. Ensures negotiations are handled efficiently to meet important deadlines and remain within approved financial parameters. Adheres to the mission, vision, and values of TriHealth. Requirements: Bachelor's Degree in Health Care Administration; Health Policy; Law; Public Health; Business Administration or equivalent experience accepted in lieu of degree. Excel, Word, and Power Point proficiency, familiar with data technology. 3-4 years experience Managed Care Contracting - Payor and/or Provider.

Created: 2025-03-04