Inpatient & Ancillary Contracting Administrator
hace 29 días
Birmingham
Job Description Inpatient & Ancillary Contracting Administrator Location: Birmingham, Alabama Why VIVA HEALTH? VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys. VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare. Benefits • Comprehensive Health, Vision, and Dental Coverage, • 401(k) Savings Plan with company match and immediate vesting, • Paid Time Off (PTO), • 9 Paid Holidays annually plus a Floating Holiday to use as you choose, • Tuition Assistance, • Flexible Spending Accounts, • Healthcare Reimbursement Account, • Paid Parental Leave, • Community Service Time Off, • Life Insurance and Disability Coverage, • Employee Wellness Program, • Training and Development Programs to develop new skills and reach career goals Job Description The Inpatient & Ancillary Contracting Administrator plays a key leadership role in the Provider Services department. This individual is responsible for developing, negotiating, and maintaining acute, post-acute, and ancillary provider contracts across Medicare Advantage, Medicaid, and Commercial lines of business. In partnership with Network Operations leadership, this role ensures contract alignment with regulatory requirements and organizational priorities, supporting the development of high-performing provider networks. This position oversees contracting activities related to hospitals, skilled nursing facilities, home health, durable medical equipment (DME), imaging, and other ancillary services. This individual also provides guidance to internal teams and serves as a subject matter expert on network adequacy, reimbursement models, and market competitiveness. This position will travel to locations within the VIVA HEALTH service area through a reliable means of transportation insured in accordance with Company policy. Key Responsibilities • Lead contract negotiations for acute, post-acute, and ancillary providers ensuring appropriate terms, rate structures, and regulatory compliance., • Evaluate network gaps and provider performance and work with Network Ops leadership on contracting strategy and prioritizing network development efforts., • Collaborate with Legal, Finance, Compliance, and Operations teams to finalize agreements that meet internal standards and Centers for Medicare and Medicaid Services (CMS)/state requirements., • Coordinate internal processes to ensure timely and accurate contract implementation, provider data entry. and system configuration., • Monitor network adequacy and escalate risks or deficiencies with recommended action plans., • Serve as a resource to Contracting and Provider Services team members by sharing expertise, standardizing workflows, and ensuring clarity of contracting priorities., • Build and maintain strong relationships with acute care hospitals, post-acute providers, and ancillary service organizations to promote collaboration and network stability., • Bachelor's Degree, • At least 3 years in Network Development, Provider Services, or Healthcare Contracting, • Valid driver's license in good standing, • Willingness to travel and engage in face-to-face provider visits; may include time spent working outside the principal office, • Strong understanding of hospital and ancillary provider reimbursement models, • Knowledge of CMS, NCQA, and state regulatory guidelines, • Excellent negotiation, interpersonal, and written communication skills, • Ability to manage multiple priorities and meet deadlines independently, • Strong attention to detail and organizational skills, • Proficiency in Microsoft Office applications, • Experience preparing reports and communicating with senior leadership, • Master’s degree in Business, Healthcare Administration, or related field, • 5 years in managed care, • 3 years in a supervisory or managerial role