Contract Administrator III, SPR

The Senior Contract Administrator will exhibit the highest level of professionalism, be service driven, detail oriented, proactive in training and messaging and possess excellent communication and analytical skills to support contracting and pricing initiatives.

Assists with research, negotiation, development, and maintenance of provider contracts and pricing rate setting for all network services. Strategic activities include extraction and evaluation of data, creation of reports, and submission of recommendations for improvements related to contract and pricing formulation, negotiations with payers, performance monitoring, support of billing/collections, legal, compliance and other internal stakeholders. Assists with advanced research, negotiation, development, and maintenance of institutional and ancillary contracts for all the Clinic's assigned product and professional service categories. Develops negotiation strategies and planning with management and administration and conducts independent negotiations, as necessary. Acts as preceptor and mentor to the Contract Administrators

Serves as resource for Revenue Cycle Management, Compliance, and other business and/or clinical units. Communicates with outside payers and internal management staff. Maintains operational knowledge of contractual agreements and is able to assist with specific contractual language for service lines. Work involves application of advanced knowledge and skills related to essential job duties: e.g., knowledge of billing, reimbursement and contract terms and conditions to properly analyze revenue, identify variances and make recommendations for resolution. Duties may be varied and complex. May be asked to assist in formulating or revising Carilion policies and procedures. Compliance with regulatory controls and Carilion performance standards required.

• Lead and support proposal preparation, contract negotiations, and administration of complex contracts.
• Financial and contractual compliance: comprehension and awareness of revenue recognition policies and key contractual terms.
• Manages internal customer and payer relationships to ensure successful contract implementation and operational effectiveness.
• Monitors and evaluates contract performance to determine necessity for amendments or contract extensions and compliance to contractual obligations. Notifies payers of all approved changes and requirements; notifies Carilion Clinic service areas of contractual changes.
• Negotiates contracts, drafts, and coordinates payor contracts, both directly and under supervision. In preparation for review and approval of senior management, converts agreements or agreement proposals into contract format, prepares amended documents to reflect necessary changes and/or alternatives. Responsible for pending contract management through good document controls.

Education: Bachelor's degree in Business, Finance or Health Administration required. Master's degree in hospital or business administration, finance or closely related clinical discipline, preferred.

Experience: Minimum of two years direct contracting experience within a hospital, consulting firm, accounting firm, or decision support vendor preferred. Requires a working knowledge of industry business practices and negotiation of contracts, including:

• Knowledge of healthcare finance
• Fee for service contracts
• DRG/ Per Diems
• Medicare CMS fee schedules
• Excellent analytical and problem-solving skills
• Clear, effective communication skills
• Proficiency in PC and mainframe-based applications such as SQL, Tableau, Power BI preferred)
• Detail orientation

Other Minimum Qualifications: Requires a working knowledge of industry business practices and negotiation of contracts. Understanding of contract management and compliance requirements. Ability to adapt to changing work assignments and shifting priorities. Possess strong written and oral communication skills, excellent interpersonal skills, and a working knowledge of PC software packages typically associated with contract administration. Ability to conduct in-depth product presentations in a variety of settings. Administratively self-sufficient, be service driven, detail oriented, proactive in training and messaging.

This is Carilion Clinic ...

An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.

Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.

Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.