Highmark Health
Job Title
This job manages contracts including negotiations, contract development, contract renewal, and financial reimbursement. Acts as the intermediary between the organization and outside entity. Responds to contractual and payment issues both internally and externally. Ensures compliance with contractual terms. Essential Responsibilities
Monitor activities by tracking the specific terms of each contract and maintaining some mechanism for monitoring and documenting compliance with those terms. Prepare periodic reports that summarize compliance with key responsibilities outlined in the agreement for both internal and external audiences. Manage contracts including negotiations, contract development, contract renewal, and financial reimbursement. Act as the intermediary between the organization and outside entity to ensure all responsibilities as outlined in the contract are fulfilled. Provide control and processing support for final provider settlements and initiating, documenting, processing, and establishing collection protocols for provider settlements. Work with sales and customer service to respond to questions/inquiries from customers/members related to appropriateness of services billed by providers. Other duties as assigned or requested. Education
Required Associates Degree in Business, Finance, Information Management, Healthcare Administration or Health related discipline Substitutions None Preferred Bachelor's Degree in Business, Finance, Information Management, Healthcare Administration or Health related discipline Experience
Required None Preferred 5 years in Healthcare administration/delivery/finance or a related field Licenses or Certifications
Required None Preferred Certified Public Accountant (CPA) Skills
Preferred working knowledge of third party payment concepts, and a solid understanding of health care finance and regional market environment Extensive experience with commonly used computer business applications to include but not limited to: Microsoft Word, Excel and PowerPoint Experience with medical terminology and coding Strong interpersonal organizational and analytical skills and the ability to perform under pressure within rigid time constraints, without the loss of efficiency, quality and professionalism as demonstrated by previous positions held Willingness and agreement to continue educational course work in direct relation to the position and travel for additional training or business purposes as necessary Demonstrated ability to analyze situations and data to identify issues, determine points of relevance and proper course of actions Superior communication (written and oral), negotiations, teamwork, and organizational skills as demonstrated through previous performance, testing and/or academic background Ability to identify, establish and meet goals and objectives Language (Other than English):
None Travel Requirement:
0% - 25% Physical, Mental Demands and Working Conditions
Position Type
Office-based Teaches / trains others regularly
Occasionally Travel regularly from the office to various work sites or from site-to-site
Rarely Works primarily out-of-the office selling products/services (sales employees)
Never Physical work site required
Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
This job manages contracts including negotiations, contract development, contract renewal, and financial reimbursement. Acts as the intermediary between the organization and outside entity. Responds to contractual and payment issues both internally and externally. Ensures compliance with contractual terms. Essential Responsibilities
Monitor activities by tracking the specific terms of each contract and maintaining some mechanism for monitoring and documenting compliance with those terms. Prepare periodic reports that summarize compliance with key responsibilities outlined in the agreement for both internal and external audiences. Manage contracts including negotiations, contract development, contract renewal, and financial reimbursement. Act as the intermediary between the organization and outside entity to ensure all responsibilities as outlined in the contract are fulfilled. Provide control and processing support for final provider settlements and initiating, documenting, processing, and establishing collection protocols for provider settlements. Work with sales and customer service to respond to questions/inquiries from customers/members related to appropriateness of services billed by providers. Other duties as assigned or requested. Education
Required Associates Degree in Business, Finance, Information Management, Healthcare Administration or Health related discipline Substitutions None Preferred Bachelor's Degree in Business, Finance, Information Management, Healthcare Administration or Health related discipline Experience
Required None Preferred 5 years in Healthcare administration/delivery/finance or a related field Licenses or Certifications
Required None Preferred Certified Public Accountant (CPA) Skills
Preferred working knowledge of third party payment concepts, and a solid understanding of health care finance and regional market environment Extensive experience with commonly used computer business applications to include but not limited to: Microsoft Word, Excel and PowerPoint Experience with medical terminology and coding Strong interpersonal organizational and analytical skills and the ability to perform under pressure within rigid time constraints, without the loss of efficiency, quality and professionalism as demonstrated by previous positions held Willingness and agreement to continue educational course work in direct relation to the position and travel for additional training or business purposes as necessary Demonstrated ability to analyze situations and data to identify issues, determine points of relevance and proper course of actions Superior communication (written and oral), negotiations, teamwork, and organizational skills as demonstrated through previous performance, testing and/or academic background Ability to identify, establish and meet goals and objectives Language (Other than English):
None Travel Requirement:
0% - 25% Physical, Mental Demands and Working Conditions
Position Type
Office-based Teaches / trains others regularly
Occasionally Travel regularly from the office to various work sites or from site-to-site
Rarely Works primarily out-of-the office selling products/services (sales employees)
Never Physical work site required
Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org