Managed Care Contract Specialist - Phoenix Children's

Posting Note: As a Managed Care Contract Specialist for Phoenix Children's, you will be responsible for evaluating, analyzing, negotiating, implementing, and monitoring contract rates and terms. Contracts may include Phoenix Children's Hospital, Phoenix Children’s Medical Group, and Phoenix Children’s Care Network, and all related entities. Your analytical expertise will focus on payment and operational issues that may be impacting the process. Your understanding of MS-DRG methodology, “fee for service”, pay for performance, “bundle payments”, and total cost of care model experience will be a perfect fit for this position. Schedule: M -F 8:00 a.m. - 5:00 p.m. Location: 3200 Camelback Phoenix, AZ ( Temporarily "remote" due to our COVID policy. ) Requirements: 3 years of healthcare experience with a focus in contract administration and negotiation, strong analytical skills for evaluating financials, an understanding of standard and innovative contract and reimbursement methodologies, including service fee, pay for performance, bundled payments. Knowledge of DRG and OPFS and total cost of care models required. Proficiency in MS (EXCEL, WORD, PowerPoint) products is required.

This position evaluates, analyzes, negotiates, implements, and monitors contract rates and terms within established contract parameters and timeframes. Contracting may include Phoenix Childrens Hospital, Phoenix Childrens Medical Group, Phoenix Childrens Care Network and all related entities.

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Provider Data Specialist

Under the direction of the manager, the Provider Data Specialist is responsible for maintaining accuracy of provider data in both internal and external databases. This position is expected to work effectively with internal and external contacts in an effort to meet all regulatory and industry provider data quality and accuracy standards. This position performs a variety of administrative and managed care contract support functions to ensure health plan requirements for provider enrollment and reimbursement are identified, communicated and coordinated both internally and with Phoenix Children`s Medical Group contracted health plans.

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