DaVita Contract Specialist II in EL SEGUNDO, California

Contract Specialist II

Description

Overview:

Responsible for theidentification and negotiation of contracts with hospitals, skilled nursingfacilities, physicians and ancillary providers in geographically diverse areasfor both existing and developing provider networks. Ensures proper administrationof the contracts through assessment of provider needs, coordination of contractdocumentation, and interfacing with MCA, Claims, IMCS, Care Management andother departments as necessary.

Essential Functions:

  • Consistently exhibitsbehavior and communication skills that demonstrates HealthCare Partners' (HCP)commitment to superior customer service, including quality, care and concernwith each and every internal and external customer.

  • Assesses and completesprovider contracting needs for all provider operations.

  • Prepares supportingdocumentation, negotiates and implements contracts of hospitals, skillednursing facilities, physicians and ancillary providers in geographicallydiverse areas for both existing and developing provider networks.

  • Coordinates thecompletion of provider pre-contractual activities including the submission ofrelevant provider contract documentation, completing of RFP and applicationinformation, financial analysis, RAT discussions, credentialing etc.

  • Prepares and/or coordinatesfinancial and utilization analyses to develop recommendations for compensationmethodologies and amounts, including capitation.

  • Cultivates positiveworking relationships with network Medical Directors and other administrativestaff.

  • Develops and maintainsclient relationships and ensures continuing client satisfaction.

  • Assists in constantanalysis of contracting needs including the assessment of claims andutilization data to identify areas for new and re-negotiated contracts.

  • Uses, protects, and disclosesHCP patients' protected health information (PHI) only in accordance with HealthInsurance Portability and Accountability Act (HIPAA) standards.

Qualifications

Education:

  • Bachelor's degreepreferred

Experience:

  • Candidate must beskilled in the area of analytics (3 years) that involved data analysis for thepurpose of contract rate development and provider and contract financialperformance.

  • 3 Years of dataprocessing

  • Preferred HealthcareExperience

Knowledge, Skills, and Abilities

  • Computer literate

  • Knowledge of Microsoftapplications (Word, Excel, Access)

  • Knowledge of managedcare

  • Excellent verbal andwritten communication skills

  • Ability to workindependently

DaVita Medical Group manages andoperates medical groups and affiliated physician networks in California,Colorado, Florida, Nevada, New Mexico, Pennsylvania and Washington. A leadingmedical group in America, DaVita Medical Group has over two decades of experienceproviding coordinated, outcomes-based medical care in a cost-effective manner.As of December 31, 2016, DaVita Medical Group’s 2,000 employed clinicians,12,000 teammates, and network of 13,000 affiliated clinicians provided care forapproximately 1.7 million patients. DaVita Medical Group’s leadershipdevelopment initiatives and social responsibility efforts have been recognizedby Fortune, Modern Healthcare, Newsweek and WorldBlu.

DaVita Medical Group is an equal opportunity/affirmative action employer. As such, DaVita Medical Group makes hiring decisions solely on the basis of qualifications and experience, and without regard to age, race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.

We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.

DaVita Medical Group will consider qualified applicants who have criminal histories in a manner consistent with the law.

Primary Location CA-EL SEGUNDO - 90245

Req ID: 322945