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To develop, maintain, implement and monitor contractual relationships with third party Insurance Payors on behalf of HFHS and its business units.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

1. Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate contractual provisions and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units.

2. Independently evaluate and analyze contract proposals including completing initial proposal responses and reviewing/revising contract language and operational requirements. Reviews contracts with in house legal-council and works through contract revisions with Payors.

3. Routinely monitor current contracts for appropriate rate structure, contract terms and annual renewals and/or re-negotiations and compliance with industry standards and guidelines.

4. Monitor marketplace for new contracting opportunities and make recommendations of changes to enhance HFHS contract portfolio.

5. Coordinate implementation of Payor arrangements and provide ongoing education and support throughout HFHS.

6. Collect and communicate relevant contractual requirements and issues to internal customers such as Utilization Management, Finance, Patient Billing, Administration, Legal, etc. Information includes; payor relationships, operational requirements and contract terms.

7. Maintain comprehensive files of HFHS contractual relationships and update contract information in the contract database.

8. Maintain contract summaries on HFHS website (Henry).

9. Act as liaison between HFHS and Payors on contracting and operational issues, i.e. billing, utilization review, credentialing site visits, notification of site closures or new services.

10.Coordinate facility credentialing and re-credentialing.

11.Perform other duties as assigned.

EDUCATION/EXPERIENCE REQUIRED:

+ Bachelors Degree in Business, Healthcare or related field.

+ Minimum of four (4) years in the healthcare industry in a professional capacity.

+ Knowledge of managed care organizations and integrated health systems.

+ Previous contracting, provider relations and/or provider reimbursement experience.

+ Comprehensive project management abilities.

+ Excellent oral and written communication and presentation skills.

+ Excellent organizational skills and ability to manage multiple projects simultaneously.

+ Excellent interpersonal skills and ability to develop effective working relationship with both internal and external customers.

+ Strong negotiation skills.

+ Understanding of legal, business, and insurance operations principles.

+ Proficient in Microsoft Word.

PHYSICAL DEMANDS/WORKING CONDITIONS:

+ Normal office environment with minimal exposure to noise, dust, or extreme temperatures.

Additional Information

+ Organization: Corporate Services

+ Department: Managed Care Contracting

+ Shift: Day Job

+ Union Code: Not Applicable

Additional Details

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .

Benefits

The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.