Job Description
**Resp & Qualifications**
**(Live in CareFirst service area)**
**PURPOSE:**
This role will lead, guide, strategize and manage negotiations for provider-specific institutional, ancillary, and professional contracts. Key responsibilities include negotiating contract terms in accordance with regulatory requirements, analyzing financial data to evaluate implications across various business lines, while ensuring compliance with company policies and procedures, and coordinating with the Payment Transformation team to transition fee-for-service arrangements to value-based care. This role will also oversee complex projects related to provider contracts, reimbursement methods, documentation and amendments, and participate in internal workgroups and committees, ensuring compliance and advising on business strategies.
**ESSENTIAL FUNCTIONS:**
**Contract Development and Negotiation**
+ Serves as a consultant and subject matter expert (SME) in contrac...
**(Live in CareFirst service area)**
**PURPOSE:**
This role will lead, guide, strategize and manage negotiations for provider-specific institutional, ancillary, and professional contracts. Key responsibilities include negotiating contract terms in accordance with regulatory requirements, analyzing financial data to evaluate implications across various business lines, while ensuring compliance with company policies and procedures, and coordinating with the Payment Transformation team to transition fee-for-service arrangements to value-based care. This role will also oversee complex projects related to provider contracts, reimbursement methods, documentation and amendments, and participate in internal workgroups and committees, ensuring compliance and advising on business strategies.
**ESSENTIAL FUNCTIONS:**
**Contract Development and Negotiation**
+ Serves as a consultant and subject matter expert (SME) in contrac...
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