Job Details: | Cape Cod Healthcare (CCHC) is an award-winning, comprehensive regional healthcare system based in Hyannis, Massachusetts with more than 500 physicians, two acute-care hospitals, home health services, skilled nursing and rehabilitation facilities, an assisted living facility and more than 4000 employees. CCHC was recently named one of the top 10 healthcare organizations in the country, according to Thomson-Reuters, a leading source of healthcare information. Quality, safety, and patient satisfaction are at the heart of everything we do! We are currently seeking a dedicated Contract Specialist to join our Managed Care team at Cape Cod Healthcare. Cape Cod Healthcare offers competitive salaries, excellent benefits packages, tuition reimbursement, and generous paid time off. PURPOSE OF POSITION: Responsible to support the Director of Managed Care in all functions related to Managed Care, PO and PHO regarding hospital and physician contracts including contract review, contract language redlining, contract negotiation, and contract warehousing. EDUCATION/EXPERIENCE/TRAINING: - A strong healthcare background with knowledge of hospitals and medical providers, and have experience dealing with commercial payors.
- Experience in contract negotiation and contract language scripting is required, with the capability to detail contracts and track changes (redline), building spreadsheets for contract inventory, and tracking contract negotiations.
- Must be familiar with hospital, physician, and ancillary commercial reimbursement methodologies and understand healthcare contract terminology.
- Knowledge of Medicare reimbursement methodologies required. Monitor changes to federal and state regulations.
- This position must be familiar with federal and state laws as they relate to managed care and Medicare.
- A Bachelors Degree is required and an MBA or MHA is preferred.
- Strong communication skills are necessary for this person to efficiently and effectively work with providers and payors. Must be outgoing, results oriented and have the ability to work as a team.
- Attention to detail is required.
- A working knowledge of MS Office software is required.
- Minimum of 6 years experience in the hospital or payer managed care environment dealing with provider contracts and reimbursement.
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