Contract Representative I

Job description

Contract Representative I

Job Title

Contract Representative I


Duration

Open Until Filled


Description

Let’s do great things, together

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality.

Today, like then, we’re focused on building a better future for healthcare.

That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees.

It keeps going by connecting with neighbors to create healthy spaces and places, together.

Moda values diversity and inclusion in our workplace.

We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity.

Our diverse experiences and perspectives help us become a stronger organization.

Let’s be better together.

Position Summary
The Contract Representative I will be responsible for preparing, reviewing, and revising routine contracts, use analytical tools and strong communication skills in negotiating challenging contract renewals, enter contracts into our contract management database, and contributing to corporate projects.

Cultivate and maintain professional relationships with providers and practices in assigned portfolios.This is a FT WFH position.



Pay Range
$53,596.39 - $67,000.66, DOE.



This role may be classified as hourly (non-exempt) depending on the applicant's location.

Actual pay is based on qualifications.

Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position.


https://j.brt.mv/jb.do?reqGK=27762275&refresh=true


Benefits

+ Medical, Dental, Pharmacy, Life & Disability

+ 401K - Matching

+ FSA

+ Employee Assistance Program

+ PTO and paid holidays ​​​​​​


Primary Functions:

+ Develops strategic relationships with key providers, negotiating annual rate increases within set parameters and guidelines within an assigned portfolio and providing recommendations to leadership on the renewal.

+ Handles complex contracts using problem solving skills to meet budget constraints, develops rapport with provider groups and/or hospitals as well as works with the Provider Analytics and Contract Pricing teams on solving complex rate methodologies within assigned portfolio.

+ Assists in the periodic assessment of Moda’s network status and recommends strategies when new trends are identified.

+ Conducts strategy development based on network analysis results.

+ Assists in the new implementation and ongoing modification of Moda’s statewide, regional, and local network strategies.

+ Utilizes best practice policies and procedures, work guides or tools to provide improved department process workflows.



+ Coordinates and participate in targeted provider meetings, including annual Provider Workshops, with Provider Relations Representatives in assigned portfolio.

+ Represents Moda at meetings and events at which contracted Moda hospitals and key Moda providers will be attending.

+ Provides ongoing support to team members.

+ Performs other duties as assigned.

Position Proficiency Requirements

+ Bachelor’s degree in Business, Finance, Health Care Administration, or 2 years’ equivalent work experience in a related field.

+ Minimum 2 years of experience negotiating contracts, specifically with ancillaries, facilities, specialty providers, and physician groups.

+ Position requires a highly self-motivated person that applies judgment in the prioritization of assignments, is organized and efficient in their approach to the work and is able to work both independently and as a team member in achieving objectives.

+ Demonstrated strong interpersonal communication skills, including strong business writing skills.

+ Possess strong analytical, attention to detail, and problem-solving skills.

+ Understanding of physician, hospital, and other provider contracts and reimbursement mechanisms.

+ Ability to work with internal stakeholder departments to create a seamless and positive experience for the provider.

+ Strong judgment and decision-making skills with ability to develop and foster strong working relationships.

+ Strong PC proficiency with Microsoft Office applications.

+ Ability to maintain confidentiality and project a professional business presence and appearance.

+ Ability to perform in a fast-paced environment with competing priorities daily.

Due to the demands placed on the Medical Provider Relations Department, the pace in the department is rapid and dynamic, sometimes causing project priorities to shift rapidly and significantly.

The Contract Representative I must be flexible, adaptable, and able to meet deadlines under pressure.

+ Ability to work well under pressure as well as with frequent interruptions and shifting priorities.

Ability to function effectively in a complex, ambiguous, demanding, and rapidly changing environment.

+ Ability to come in to work on time and daily, working the hours required to support the team and meet all goals and objectives.


Together, we can be more.

We can be better.
​​​​​​
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.



For more information regarding accommodations please direct your questions to Kristy Nehler and Danielle Baker via our humanresources@modahealth.com email.

Required Skill Profession

Other General