Contract Specialist

Reviews contracts and facilitates contracting with the VNS Health Plans provider network as it pertains to all provider types and for all VNS Health offered products. Negotiates and coordinates the implementation of provider agreements. Supports the strategic alignment of the network to align the company's various product offerings. Works under general supervision.

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  Negotiates contractual terms, services and rates of reimbursement with providers to foster network expansion and maintenance within established guidelines.

• Negotiates single case and letter of agreements for out of network providers.

• Reviews contracts to ensure regulatory and financial compliance.

• Ensures that all contract templates are compliant with State and Federal guidelines.

• Manages the implementation of key agreements.

• Works with other VNS Health business units to coordinate efforts and leverage resources in provider contracting, network performance, reimbursement and other related matters.

• Keeps abreast of current industry trends, governing regulations, reimbursement practices and market players. Keeps VNS Health Plans management informed of trends/changes and makes recommendations based on this information.

• Participates in special projects and performs other duties as assigned.

Education:

• High School Diploma required

• Associate's Degree in related field preferred

Work Experience:

• Minimum four years of experience in health care, with a minimum two years of experience in provider relations or contracting capacity required

• Experience working with network service providers and negotiating/administering contracts required