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About the Role

The Contract Administrator - System Payer Contracting supports the development of contracting strategies, negotiates with payers, and prepares contract proposals. This role involves preparing for and conducting meetings, negotiations, and presentations.

Responsibilities

• Meets with payer representatives to evaluate current contracts or develop new contracting opportunities.
• Reviews proposals and makes data-informed recommendations for negotiations.
• Negotiates contract parameters and methodologies, preparing and presenting proposals.
• Evaluates and develops proposals, identifying opportunities and risks.
• Collaborates with Legal and Compliance departments to ensure compliance and implementation.
• Reviews terms and performance of established contract portfolios.
• Mediates contract disputes and ensures compliance with contract provisions.
• Monitors contract renewal dates and coordinates contract analyses.
• Reviews for risks and works with Financial Reporting to ensure appropriate modeling.
• Monitors contract performance by collecting and analyzing data, completing spreadsheets, and preparing reports.
• Maintains knowledge of payers in the market and gathers data on managed care organizations.
• Maintains confidentiality of patients and contracts.
• Performs special projects and assignments as requested.
• Assists with affiliate contracting processes related to payer contracting.
• Maintains current knowledge of Federal and New York State regulations regarding medical services and reimbursement.

Requirements

• Minimum of 4 years in managed care negotiations and managed care network operations required.
• Minimum of 1 year of experience in leading complex payer negotiations and mediation is required.
• Equivalent combination of relevant education and experience may be substituted as appropriate.
• Workforce members are expected to ensure that access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties.
• Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose.
• Reasonable efforts shall be made to ensure that information is adequately protected from unauthorized access and modification.

Skills

• Data-supported recommendations
• Contract proposal preparation
• Negotiation
• Presentation
• Cross-functional collaboration
• Data analysis
• Financial modeling
• Contract dispute mediation
• Knowledge of Federal and New York State regulations

Location

• Albany, NY

Work Type

• Day Shift
• Travel to affiliate locations required

Experience Level

• 4 years in managed care negotiations and network operations
• 1 year in leading complex payer negotiations and mediation

Education Level

• Bachelor's Degree in Business and/or Health Care Administration

Salary/Compensations

• $77,075.00 - $119,466.00

About the Company

• Albany Med Health System is a healthcare system.
• This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes.

Equal Opportunity

• Albany Med Health System is an equal opportunity employer.