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Contract Management (Provider Contracts)

Location: Renton, WA Job Number: 886793 Date posted: 08/19/2020

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Manages the provider contracting process from service delivery planning through implementation including ongoing monitoring & evaluation, to ensure KFHPW divisions meet EDS budget targets and year end performance objectives.

Essential Responsibilities:
  • Authors the contract document and ensures the complete & appropriate KFHPW implementation of contractual arrangements, in accordance with payment policy and KFHPW business & system requirements. Reviews and approves all contracted provider network information prior to publication/ marketing
  • Acts as lead negotiator (e.g. proposal development & execution) for the Provider Relations/ Delivery System team in negotiations with community providers (e.g. hospitals, multi-specialty groups, large for-profit vendor organizations, skilled nursing facilities, etc.).
  • Conducts and/or oversees financial modeling and recommends financial terms meeting payment policy and divisional objectives of KFHPW Delivery System leadership.
  • Provides knowledge, information, consultation and decision level recommendations to inform service delivery planning, provider selection and retention process. Serves as single point of contact between Provider Relations and accountable delivery system divisional management on a service line basis.
  • Identifies, recommends and facilitates timely resolution of provider training & enhancement strategies to achieve maximum value from contracted relationships. Facilitates problem resolution strategies involving a variety of KFHPW departments including Legal, Claims, Membership Patient Financial Services, Delivery System, Provider Services, etc.
  • Basic Qualifications:
  • Minimum four (4) years of health care to include minimum one (1) year of health care/medical/insurance contract negotiations experience.
  • Education
  • Bachelor's degree in related field.
  • License, Certification, Registration
  • N/A

  • Additional Requirements:
  • Working knowledge of various reimbursement methodologies including risk arrangement.
  • Strong analytic; written and verbal communication; and customer service skills.

  • Preferred Qualifications:
  • Seven (7) years of health care experience to include four (4) years of health care/medical/insurance contract negotiations experience and prior delivery system operations experience preferred.
  • Master's degree in health, business administration, public administration or public health.
  • Primary Location: Washington,Renton,Renton Administration - Baker 1300 SW 27th St. Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: Varies Working Hours End: Varies Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Manager with Direct Reports Job Category: External Medical Services Department: Provider Contracting Travel: Yes, 5 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

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