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Contracting Specialist

Company: ApolloMed
Location: Alhambra
Posted on: January 15, 2022

Job Description:

Contracting Specialist Job Description
ApolloMed (NASDAQ: AMEH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise in order to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
With over a million managed lives across the country and terabytes of data generated, our software and applications need to be cutting-edge, efficient, and aligned with our core values of improving patient outcomes and empowering our providers.
We are looking for a full-time Contracting Specialist to join our fast-growing team in Los Angeles (Remote work - Open).

You are:
Comfortable with ambiguity and biased towards action. You can identify the 20% of the work that leads to 80% of the result, and mobilize and execute the high-impact work consistently. You enjoy thinking about complex and ambiguous problems and can execute consistently and add compounding value.
Relentlessly resourceful. You enjoy taking ownership and can motivate others to get things done. You are resilient, detail-oriented, and truly believe that no task is beneath you, even in the face of potential challenges.
Growth-oriented. You are able to evaluate all perspectives, even if uncomfortable, and have the courage to adjust your views if necessary. You have the expertise and communication skills to balance a growth mindset with a bias towards action.
Mission-driven. You are excited by the prospect of diving into complex problems that will drastically improve patient outcomes, while lowering the cost of a tremendously inefficient US healthcare system, where waste is over 40% and per-capita healthcare dollars spent is double that of other developed nations.

What you'll do:
Interpret provider-facing and payor-facing agreements for time sensitive negotiations.
Perform both data and contractual analysis in support of negotiations.
Assist, drive, and implement cross-functional Contracting-related changes to preexisting Operations.
Identify, communicate, and implement operational inefficiencies within ApolloMed's Contract Management Software System.
Efficiently and accurately coordinate the flow of contracts to all relevant stakeholders.
Become a subject-matter Expert in all things related to strategic contract negotiations to improve both the quality of value-based care and the financial strength of ApolloMed.
Make strong judgement calls with justifications for all contracting questions.
Work directly with Claims, Configuration, Business Development, and Data Management teams to gather reports regarding negotiation rates.
Prepare and analyze reports for committee meetings.
Responsible for tracking, analyzing, forecasting, and reporting on vendors & physicians' financial impact.
Prepare and review the cost-benefit analysis & medical cost ratio for existing/new/term vendors and providers.
Identifying, developing, and documenting audit findings and discussing the findings with key players.
Identifies cost of care savings opportunities by analyzing physician authorizing/billing patterns in relation to hospital admissions, emergency room visits, office visits, referral practices, and specialty care procedures and provide suggestions for vendor contract changes that can result in cost savings.
Review and analyze budget & expenditures against projects based upon various funding sources associated with vendor/provider recruitment and network expansion.
Review and analysis of monthly cost reports and monthly progress reports per physicians and vendors.

The opportunity:
Join a team with extremely high-level visibility; you will be working closely with Management and Directors work and negotiate with all Provider and Ancillary agreements.
Startup-like mentality and career trajectory in a recently IPO'd company (> 4B market cap) targeting 100%+ growth YoY in 2022
Be the first contact to help ApolloMed positively impact millions of patients and thousands of healthcare providers

Minimum qualifications
Bachelor's Degree required or equivalent experience in the healthcare industry.
Minimum of 2 years of contracting/negotiation/payor/provider relations experience in the healthcare or related industry.
Medium-high level of comfort working with numbers and large bodies of text.
Knowledgeable in analytics with strong problem-solving skills. Capable of showcasing a methodical approach to troubleshooting.
You are meticulous, highly organized, and able to engage in exhaustive investigation when initial information is vague.
Excellent communication skills - both verbal and written. Experience in technical writing is a plus.
Has at least 1 year claims audit experience and understands how to negotiate proper payment - preferred.
Strong comfortability with Microsoft Office Suite (Excel, Word, PowerPoint).
Very knowledgeable with EZ-Cap and able to understand and work with proprietary software applications - preferred.

Keywords: ApolloMed, Alhambra , Contracting Specialist, Other , Alhambra, California

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