Contracting Specialist - AHMC Healthcare Inc
Alhambra, CA 91801
About the Job
POSITION SUMMARY
The Contracts Specialist is responsible for negotiating ancillary and health plan agreements on behalf of AHMC hospitals.
AHMC provides consulting services to seven acute care hospitals, AHMC Anaheim Regional Medical Center with 223 beds, Garfield Medical Center with 210 beds, Greater El Monte Community Hospital with 117 beds, Monterey Park Hospital with 101 beds, Parkview Community Hospital with 191 beds, San Gabriel Valley Medical Center with 273 beds, and Whittier Hospital Medical Center with 178 beds. The facilities are Medicare and Medi-Cal certified and accredited by the Joint Commission on Accreditation of Healthcare Organizations. The hospitals provide healthcare services reimbursed by Medicare, Medi-Cal, traditional insurance plans, PPO, HMO and under capitated arrangements.
TRAINING/EXPERIENCE
- A minimum of 18 months Managed Care Contracting experience preferred
- Proficient in Microsoft Excel.
- Thorough understanding of the healthcare market and Managed Care operations.
- Strong personal communication and critical thinking skills.
EDUCATION/CERTIFICATION/LICENSE
Bachelor’s Degree from an accredited college is preferred or a combination of work related experience and high school diploma.
ESSENTIAL JOB FUNCTIONS
- Negotiates ancillary services agreements
- Negotiates and processes one-time agreements (MOUs, LOAs, etc.) for our network cases.
- Provides contracting support to the Managed Care Department.
- Develops and maintains relationships with ancillary providers as well as hospital and group/IPA Case Managers
- Assists with the resolution of provider disputes with ancillary agreements.
- Oversees the distribution of Managed Care contracts throughout the company.
- Abides by AHMC Code of Conduct, Policy and Procedures, and HIPAA compliance.
- Performs additional duties as assigned.
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