Department
Managed Care
Job Summary
The Managed Care Contracting Liaison will support the managed care contracting team during negotiations with Insurers, Payers, Brokers, and Employers, including, drafting of contract language and providing regulatory reviews in connection with all organization managed care contract offerings and relationships; negotiating, drafting, redlining, and reviewing a wide variety of managed care agreements, and providing other services as needed in support of organization’s business operations. Manages organization’s payer disputes and interacts with outside legal counsel, as necessary to facilitate resolution. Demonstrates a knowledge of managed care/healthcare law and extensive contract negotiation skills in connection with payer relations, contract negotiations and contract disputes. Comprehends and contributes to the managed care strategy and associated legal support. Assists in the oversight of the administration of managed care contracts including operational issues and disputes related to organization’s managed care agreements. Effectively communicates with team members and collaborates with various internal stakeholders and often works independently. Demonstrates a willingness to work in a high-pressure, fast-paced environment and has the ability to manage multiple projects at one time.
Required Qualifications
- Require a Juris Doctorate (JD) degree from an ABA Accredited Law School.
- Require a minimum of three (3) years of relevant (i.e., negotiations, regulatory, clinical, etc.) experience with at least two (2) years working with the development and/or administration of contracts.
Preferred Qualifications
- Prefer demonstrated superior contract drafting and negotiation experience is essential, including the negotiation of complex multi-year contracts.
- Prefer knowledge of the regulatory framework of health plans, including a working knowledge the Florida healthcare statutes and the insurance laws impacting plans in Florida and other states.
- Prefer knowledge of healthcare regulations affecting managed care contracts and relationships, including HIPAA (privacy, security, and standard transactions); Medicare secondary payor; anti-kickback and anti-inducement and the False Claims Act.
- Prefer demonstrated research, analytical, organizational and computer skills.
- Prefer excellent written, oral, and listening communication skills; negotiation skills, leadership and facilitation skills.
- Prefer demonstrated initiative and an ability to work in a fast-paced, complex organization.
- Prefer demonstrated strong client management and project management skills and ability to work successfully both independently and within a team.
- Prefer prior experience as an associate or partner of a healthcare law firm, or firm involved in complex contract negotiation and dispute management. Knowledge of laws related to not-for-profit healthcare operations is preferred.
Mandatory Education
Preferred Education
Required License and Certs
Preferred License and Certs
- Prefer demonstrated superior contract drafting and negotiation experience is essential, including the negotiation of complex multi-year contracts.
- Prefer knowledge of the regulatory framework of health plans, including a working knowledge the Florida healthcare statutes and the insurance laws impacting plans in Florida and other states.
- Prefer knowledge of healthcare regulations affecting managed care contracts and relationships, including HIPAA (privacy, security, and standard transactions); Medicare secondary payor; anti-kickback and anti-inducement and the False Claims Act.
- Prefer demonstrated research, analytical, organizational and computer skills.
- Prefer excellent written, oral, and listening communication skills; negotiation skills, leadership and facilitation skills.
- Prefer demonstrated initiative and an ability to work in a fast-paced, complex organization.
- Prefer demonstrated strong client management and project management skills and ability to work successfully both independently and within a team.
- Prefer prior experience as an associate or partner of a healthcare law firm, or firm involved in complex contract negotiation and dispute management. Knowledge of laws related to not-for-profit healthcare operations is preferred.
$0 per YEAR Employment Type: Full-Time