SUMMARY OF RESPONSIBILITY:

This position is critical to SoNE HEALTH’s performance through supporting the negotiation, implementation and management of fee-for service and value-based arrangements across business lines. SoNE HEALTH members include acute care hospitals, rehabilitation hospitals, freestanding facilities, ancillary providers, employed and independent physicians and advance practice clinicians across Connecticut and Massachusetts. This role will work collaboratively with SoNE and Trinity Health personnel to deliver timely and effective results that support local, regional and system needs.

This role is located at the company's headquarters in Windsor, CT, and operates in a hybrid environment.

ESSENTIAL FUNCTIONS:

• Supports SoNE HEALTH in contract negotiations and managing the operational relationships with payers including evaluating rates, payment methodologies, contract language and value-based payment programs
• Establishes and communicates project plans and schedules for each new agreement or agreement renewal to ensure that preparations and negotiations are conducted in a timely manner
• Works with payers to ensure that data and other key materials are effectively shared throughout the negotiation cycle
• Accountable for maintaining accurate contractual information in electronic systems
• Establishes and maintains effective relationships with payer personnel to enhance our ability to achieve key strategies and outcomes
• Supports contracting efforts by serving as a contract expert and providing information about specific terms, including interpretation and / or intent
• Supports SoNE HEALTH by providing reimbursement and fee schedule related information, and communicating with the appropriate payer representatives about modeling results
• Actively pursues continued development / enhancement of skill sets; maintains industry knowledge of the regulatory environment impacting payer relationships’ as well as evolving trends in managed care contracting and healthcare in general
• Performs other duties, as assigned

The duties listed above are intended only as illustrative of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar or a logical assignment to the position.

QUALIFICATIONS AND COMPETENCIES:

• Bachelor’s Degree or equivalent experience
• 3-5 years of experience in a healthcare contracting environment
• Broad understanding of managed care contracting models including reimbursement strategies, non-rate terms, fee for service and value-based arrangements
• Broad understanding of health delivery operational challenges including hospital and physician practice environments
• Must have effective communication skills, as well as the ability to create clear and articulate correspondence and documents
• Ability to collaborate and assess multiple perspectives when working to understand and help resolve provider / payer contracting issues
• Strong organizational skills to keep multiple projects and initiatives moving forward and to meet local, regional and corporate needs
• Attention to detail

PHYSICAL AND MENTAL REQUIREMENTS:

The Physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to work long hours – over eight in a workday, and over 40 in a work week as necessary
• Regularly required to use hands to finger, handle or feel objects, tools, or controls; reach with hands and arms; and talk or hear
• Frequently is required to walk and sit
• Occasionally required to stand; climb or balance; and stoop, kneel, crouch or crawl
• Ability to lift and/or move up to 20 pounds
• Vision abilities required by this job include close vision, color vision, peripheral vision, depth perception and ability to adjust focus
• The dexterity necessary to utilize a computer keyboard on a regular basis is essential

ADDITIONAL REQUIREMENTS:

As a condition of employment at SoNE HEALTH and for the safety and well-being of our employees:

• All employees must reside in New Hampshire, Rhode Island, Maine, Vermont, Connecticut, or Massachusetts.
• All employees are required to be fully vaccinated for influenza and COVID-19.

SALARY: $80,747 - $104,972