Payer Strategy Contract Specialist

Where You’ll Work

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Job Summary and Responsibilities

As our Payer Strategy Contract Specialist, you will work closely with leadership to support the negotiation of favorable terms for various agreements within the managed care landscape. Your expertise will be applied across a range of organizational entities.Every day, you will focus your efforts on ensuring that all terms and conditions of these agreements adhere to organizational standards and recognized best practices. You will meticulously align contract terms with broad operational objectives, contributing to the financial sustainability and strategic goals of the organization.To be successful in this role, you will possess a strong understanding of complex contracting, effective negotiation support skills, and meticulous attention to contractual details. Your ability to collaborate effectively with leadership, interpret intricate agreement language, and ensure compliance with internal standards will be essential in navigating payer relationships.

• Supports the review of contract proposals, language and rate sheets to ensure accuracy, completeness and in compliance with CommonSpirit Health standards and guidelines.
• Recommends corrections, changes and any language opportunities in documents to PSR leadership
• Assists PSR leadership with developing and updating project plan documents, meeting minutes and action item follow up related to National Payers renewals and planning.
• Ensures all amendments, letters of agreement (LOA), memorandum of understanding (MOU) and other contract documents are signed by the appropriate parties and provide the fully executed contract documents to the Contract Administration team.
• Ensures contract documents include rate escalators and obtain updated rate tables fee schedules and all contracting materials are stored according to PSR and/or Legal Policies, and ensures information is made available to or disseminated to key stakeholders of the negotiation process.
• Coordinates with other PSR team members to facilitate credentialing and re-credentialing of CSH entities.

Job Requirements

Required

• Bachelors or equivalent education and experience
• Three (3) years’ contract management experience in a healthcare related field