Position Highlights:

The Managed Care Contract Specialist is responsible for negotiation, maintenance, issue resolution and internal coordination of assigned managed care contracts and proposals for Moffitt Cancer Center and Moffitt Medical Group under the guidance of the Director of Managed Care. The Managed Care Contract Specialist performs contract language review and negotiates language and rates with payers to maximize reimbursement, reduce exposure, and streamline administration. This position will manage payer relationships, gather and analyze data for managed care contract negotiations, communicate contract terms and conditions to appropriate internal parties, maintain contract specific reference materials, research and resolve managed care related issues, and collaborate with internal team members on the analysis of contract performance and compliance.

Ideal Candidate:

• Knowledge of governmental and commercial payers.
• Involvement in research, analysis, and interpretation of financial data and trends.
• Knowledge of hospital/physician reimbursement methodologies, claims, credentialing, and loading processes.
• Ability to manage multiple priorities and projects with strong organizational skills.
• Ability to build and maintain strong business relationships with internal and external clients including third party payers.
• Demonstrated knowledge of Federal and State Regulations, including Medicare, Medicaid, and ERISA.
• Strong Microsoft Office (Word, Excel, Outlook, PowerPoint) skills.
• Effective oral and written communication skills. Strong interpersonal skills.
• Established negotiation skills including the ability to influence those over whom he/she has no formal authority.
• Skill in composing and editing documents to include contracts, correspondence, and reports.
• Strong presenter, capable of engaging other subject matter experts and able to command the flow of discussion.

Responsibilities:

• Negotiate facility and physician managed care contracts and letters of agreement.
• Collaborate with internal teams on payer issue resolution.
• Support Managed Care Operations.
• Support patient access related to managed care delays and issues.
• Other Duties

Credentials and Qualifications:

• Bachelor’s Degree in Healthcare, Finance or related field.
• Minimum three (3) years of managed care contracting or payer relations, either in a hospital, health system, or managed care organization.

Preferred:

• Direct experience negotiating managed care contract language and rates.