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Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals.

On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country.

J ob Summary

Negotiates, operationalizes and manages contracts with all payers, e.g., insurance companies, MSOs and TPAs. Assures contractual arrangements meet financial targets and legal/regulatory compliance requirements. Facilitates the approval process of all contract documents from pre-contract through post-signature phases. Responsible for the accuracy of supporting documentation for contracts and completing documents accurately. Maintains processes that provide timely notification of critical contract events (e.g., renewals, termination and due dates contained within the agreements). Maintains existing relationships with contracted payers and providers. Ensures contractual language is current. Coordinates and communicates contractual terms to the required internal departments. Develops and maintains periodic (e.g., bi-weekly) reports on the status of all contracts. Maintains excellent written and verbal communication with all internal and external customers. Ensures provider reimbursement and language negotiations align with company guidelines. Collaborates with internal and external stakeholders to understand their needs and requirements. Collaborates with legal counsel to ensure contracts are compliant, mitigate risks, and resolve disputes. Coordinates with providers and credentialing department to ensure compliance and completeness. Leads collaboration efforts with other business units to complete contracting, process improvements, and system enhancements on behalf of Contracting. Oversees special projects. Assists with all contracting administration and projects, as assigned. Manages Capitation Claims Operations, staff and vendors including, but not limited to, Health Plans claims audit. Evaluates, negotiates and executes a wide variety of different contracts and transactions. Negotiates HMO, PPO, Medicare and Medi-Cal agreements including full risk arrangements. Creates and maintains relationships with payers and serves as point of contact for matters concerning contracts. Maintains records for correspondence and documentation in relation to established contracts and those in progress. Monitors contracts and moves forward with close-out, extension or renewal according to what’s best for Emanate Health. Solves any contract-related problems that may arise with other parties and internally with Emanate Health itself. Assists in developing presentation materials for internal and external meetings. Provides information to support strategic planning and other management decisions.

Job Requirements

M inimum Education Requirement :

Bachelor's degree in a related field preferred.

Minimum Experience Requirement :

Five years' managed care negotiation experience. HMO hospital agreement negotiation experience required. Excellent customer service skills required.

Delivering world-class health care one patient at a time.

Pay Range:

$53.37 - $78.45

We are more than just a health system. At Emanate Health, we are a catalyst for change and a beacon for healthier lives.

When you come to any one of our locations (https://www.emanatehealth.org/locations/) , you'll be treated like family. And as part of our family, you can rest easy knowing we'll do whatever it takes to benefit your health and wellness.

Our mission

Emanate Health exists to help people keep well in body, mind and spirit by providing quality health care services in a safe, compassionate environment.

Our vision

We are an integral partner in elevating our communities' health.

Our values

Patients and their families are the reason we are here. We want them to experience excellence in all we do through the quality of our services, our teamwork, and our commitment to a caring, safe and compassionate environment.

Respect. We affirm the rights, dignity, individuality and worth of each person we serve and of each other.

Excellence. We maintain an unrelenting drive for excellence, quality and safety, and strive to continually improve all that we do.

Compassion. We care for each person and each team member as part of our family.

Integrity. We believe in fairness and honesty and are guided by our code of ethics.

Stewardship. We wisely care for the human, physical and financial resources entrusted to us.

Emanate Health is an Equal Opportunity Employer and does not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify the Human Resources Department by calling 626-858-8515.