Managed Care Contracting Consultant
Managed Care Contracting Consultant
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Job Description
Job Description:
Job Description: Managed Care Contracting Consultant
WeiserMazars the independent U.S. member firm of Mazars Group ranks as the 24th largest audit tax consultancy and advisory firm in the nation and the 8th largest in the New York Metropolitan area. We are seeking a seasoned Managed Care Contracting Consultant to join our rapidly expanding Health Care Consulting Group in our New York office.
This position is responsible for developing and maintaining effective working relationships with complex providers (institutional providers large medical groups and ancillary providers) managed care organizations and other third party payers regarding negotiation or renegotiation of viable financial arrangements for our Clients.
The ideal candidate will have detailed knowledge of current healthcare industry trends and demonstrate the flexibility to respond to new ideas and approaches. This position will work with senior management and the healthcare analytics teams to develop contracting strategies identify and evaluate financial opportunities negotiate favorable reimbursement rates and advise Clients on optimal solutions.
Job Responsibilities:
- Analysis of financial data and development contracting strategies
- Interpret and communicate contract language and reimbursement terms
- Negotiate and finalize rates payment terms and language that are acceptable and approved by Clients
- Incorporate new state and federal regulations and industry standards into contract language
- Responsible for maintaining positive client relationships and quality of the work executed
- Perform all consulting engagements to the highest quality standards
- Ability to execute multiple projects simultaneously and achieve successfully results
- Participate in a highly collaborative environment within the healthcare consulting group
Job Requirements:
- Bachelors degree in Healthcare or BusinessRelated field
- Minimum of 5 years of managed care experience required either at a managed care organization or large health system
- Prior experience analyzing data for a healthcare entity
- Strong knowledge of claims and membership data is a plus
- Knowledge of Commercial Medicare Medicaid Health Benefit Exchange Products and Accountable Care Organizations
- Proficiency in Microsoft Office Suite particularly advanced Excel skills
- Understanding of Payment Methodologies e.g. AP DRGs APR DRGs CMS MS DRGs APGs APCs Medicare Physician Fees St. Anthonys and RVUs
- Familiarity of Alternative Payment Arrangements e.g. Shared Savings Risk Capitation and Value Based Contracts
- Experience with Specialty Services including Behavioral Health Dental Outpatient Rehab Home Care IVF and Transplants
Benefits:
- Salary commensurate with experience
- Bonuseligible
- Comprehensive Medical and Dental Plans
- 401(k) Plan
Please send your resume and salary history in confidence to . Refer to ID# HC/CON. Unfortunately we will only respond to those applicants in whom we have an interest. EOE.
Required Experience:
Contract
Employment Type
Full-Time
