Contract Negotiator

Description & Requirements

Join Our Team and Make a Difference!

Are you looking for an impactful role where you finish the workday knowing you helped someone? Whether you are part of our care coordination team or playing a supporting role, the work our colleagues do every day enables us to collectively reach our mission of getting people the care they need when they need it. By staying committed to our core values of Think Big, Go Fast, Deliver Awe, and Win Together we can positively impact the lives of the injured workers we serve and get them back to the things that matter most in life.

Salary Range

This compensation range considers a wide range of factors, including, but not limited to, skill set, experience and training, licensure and certifications, and other business and organizational needs. The disclosed range estimate is not adjusted for geographic differential associated with the location where the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role, and compensation decisions are dependent on the facts and circumstances of each case.

What We Provide in Return for Your Commitment to Our Mission

We offer a vast array of benefits to help support the whole you, including:

• Remote Work: We are a remote-first company and almost all positions receive the flexibility of working from home.
• Generous Time Off: Besides 8 company holidays and 2 personal days every year, all colleagues receive a minimum of 18 days of paid time off.
• Comprehensive Benefits Package: Including medical, dental, vision, and pet insurance; 401(k) matching program; and company-paid life insurance and short and long-term disability coverage.
• Supportive Services: Just like our colleagues get injured workers the care they need when they need it, we want to do the same for our colleagues in their time of need. We offer a Colleague Assistance Program that provides free counseling and financial services, and our One Call Foundation, a non-profit arm of our company, provides colleagues financial assistance during times of unexpected hardships.
  
  

JOB SUMMARY:

Responsible for the development, implementation, and management of cost-effective provider contracting arrangements for assigned product(s) and region(s). Improves company margins, grows revenue, and proactively develops the breadth of our network across all products through effective negotiations with existing and prospective providers. Provides timely and accurate reports and analyses concerning the potential margin and/or revenue impacts for assigned product(s)/region(s). Performs all critical functions necessary to assess, develop, maintain, and/or strategically improve network adequacy and access. Responsible for the partnership maintenance of existing network panel as well as the building of new lasting provider partnerships. Functions as liaison for internal departments to ensure contract language supports the business needs, processes, and initiatives through the insertion of program addenda, service level agreements, and language necessary to protect One Call, its patients, and customers.

Essential Duties & Responsibilities

Make It Happen: 50%

• Network development and recruitment through a multitude of channels (e.g., Adequacy market identification, Single Referral Agreement), Join Our Network, Implementation support, Product support, Sales and customer nominations, Total Spend Analysis, Operations coverage support).
• Ensures cost containment through strategic contract pricing arrangements, network development, and targeted renegotiation efforts.
• Margin preservations and/or improvement via rigorous pricing analyses.
• Revenue growth through Total Spend Analysisand retro opportunities.
• General contracting maintenance and network retention (e.g., termination avoidance, TIN change, name change, acquisitions, divestitures product/practitioner additions and removals etc.).
• Exercises good judgement in the course of processing and administering contractual documents inclusive of required exhibits, attachments, contract language etc.
• Strategic fee-for-service negotiations based on Medicare, Work Comp, and other internal pricing benchmarks.
• Establishes relationships with new providers and matures relationships with existing providers.
• Manages contracting workload and actively follows up on outstanding items required to process agreements.
• Responds to inquiries regarding contractual obligations and revisions.
• Collects all required initial credentialing documents and assists with the collection of re-credentialing documents as needed.
• Performs other related duties as assigned.
  
  

Engage Others: 20%

• Support internal Sales and Product initiatives to onboard new customers and/or launch new products/services through network development and retention.
• Collaborate with Operations to understand and help solution staffing challenges and network deficiencies through network development and retention.
• Partner with Account Management, Physician Sales, and Strategic Partner Solutions to direct negotiations on significant revenue generating opportunities.
• Contribute to the success of Provider Engagement, Credentialing, and Provider Data Management Teams by assisting in special projects and supporting provider re-education.
  
  

Adapt and Learn: 30%

Required

Each contracting team member is assigned to specific product(s) and region(s). To effectively manage their assigned product(s)/region(s), they are required to perform the following functions:

• Ensure network composition includes an appropriate distribution of providers, products, and/or services within specified time and distance standards.
• Regularly perform network gap analyses and create strategic action plans to improve adequacy and accessibility.
• Responsible for managing cost and margins by utilizing and adhering to established pricing parameters.
• Must possess or quickly ascertain knowledge of regional nuances that could prohibit successful network development and growth.
• Possess the ability to articulate adequacy and/or negotiation barriers and key driving factors to leadership and internal stakeholders.
• Determine cost savings opportunities and pricing optimization strategies.
• Actively evaluates provider coverage area(s), updates zips, counties, program participations such as auto assign and/or RFPs to ensure all available options are visible and steering to the most appropriate provider options.
  
  

EDUCATIONAL AND EXPERIENCE REQUIREMENTS:

• Bachelor's degree (B.A. or B.S.) or equivalent combination of education, training, or work experience.
  
  

ESSENTIAL KNOWLEDGE, SKILLS & ABILITIES:

• General knowledge of the workers compensation industry.
• Excellent verbal and written communication skills to technical and non-technical audiences of various levels. within the organization (e.g., executive, management, individual contributors).
• Excellent problem solving, time management, and work prioritization skills.
• Ability to manage multiple deadlines for self and others.
• Requires proficient negotiation skills and tactics, both written and verbal.
• Self-starter with experience handling high work volume and multiple projects.
• Possesses critical thinking skills and confidence to propose out-of-the-box solutions.
• Ability to establish and maintain relationships with internal and external customers.
• Comfortable with change and possesses the ability to switch tasks and priorities seamlessly.
• Demonstrates active listening and gives full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, not interrupting at inappropriate times, understanding the implications of new information for both current and future problem-solving.
• Skills in communication, listening and reading comprehension, and writing.
• Uses logic and reasoning to identify the strengths and weaknesses and identifies alternative solutions or approaches to processes, workflows, and problems.
• Must be able to successfully maintain multiple projects simultaneously, be detail-oriented and possess strong organizational skills. Must possess the ability to interact with others in a positive manner and be a team player.
• Experience utilizing financial models and analyses in negotiating network rates.
• Ability to operate MS Office suite effectively: Word, Excel, PowerPoint, Outlook, Teams etc.
• Ability to work in an environment that aligns with the company's diversity, equity, inclusion and belonging standards.
• Ability to work both independently and in a team environment.
• Demonstrate our core values of Think Big, Go Fast, Deliver Awe, and Win Together.
  
  

PHYSICAL/MENTAL DEMANDS & WORK ENVIRONMENT:

• This position will be performed in the colleague's home. Work-from-home requirements include the colleague's ability to set up computer equipment within their home office.
• This job is primarily sedentary and may involve repetitive motions; the colleague must be able to remain in a stationary position for extended periods of time, operate a computer and other office equipment, assess information and files stored electronically, and converse/exchange accurate information with others, simultaneously.
• The colleague must be able to discern text displayed on a monitor, input data into specific fields using a keyboard, and adjust focus to distances of up to three feet.
• The colleague must have the ability to learn new tasks, follow established processes, maintain focus, complete tasks independently, complete multiple tasks simultaneously, communicate professionally with colleagues and customers, and complete tasks in situations that have a speed or productivity requirement.
• The colleague must be able to manage moderate to significant mental stress as a result of, but not limited to, a dynamic and heavy workload.
  
  

Please be advised that job descriptions typically change over time as business needs, job requirements, and employee skill levels change. As such, One Call retains the right to change or assign other duties to this position at any time.

Contract Negotiator

Has sufficient understanding of contract language and/or rate negotiation principles. Generally, is responsible for multiple Providers for contract drafting and negotiation and manages a mid to moderately high sized region. Possesses adequate business negotiation principles, business acumen and/or contract language knowledge. Works under minimal supervision on moderately strategic, complex projects. Moderate latitude for independent judgment. Typically requires a minimum of two to five (2-5) years of related experience.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, nationality, disability status, protected veteran status, or any other status protected by law.

• PandoLogic. Keywords: Contract Negotiator, Location: Helena, MT - 59604 , PL: 596764267