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Managed Care Contracts Specialist (Full-Time, 40 Hours, Day Shift)

Company

The Queen's Health Systems

Location

Honolulu, United States

Type

Full-time

RESPONSIBILITIES

I. JOB SUMMARY/RESPONSIBILITIES:
• Assists in development, maintenance and administration of the medical centers’ contracts with health insurers for services provided to members.
• Performs financial analysis, operational evaluation, and compliance issues on payer agreements to recommend action for executive review.
• Makes recommendations for optimal member utilization and objective financial criteria.
• Functions as a member of the contracting team to negotiate optimal contractual agreements.
• Responsible for maintenance of contract modules.
• Serves as a liaison with selected payers to promote the service of the medical center and improve provider relations with third party payers.

II. TYPICAL PHYSICAL DEMANDS:
• Essential/continuous: Sitting, finger dexterity seeing, hearing, speaking, repetitive arm/hand motions, static gripping of an object for prolonged periods, frequent gripping of an object.
• Operates compute...

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