Inpatient & Ancillary Contracting Administrator
The Inpatient & Ancillary Contracting Administrator plays a key leadership role in the Provider Services department. This individual is responsible for developing, negotiating, and maintaining acute, post-acute, and ancillary provider contracts across Medicare Advantage, Medicaid, and Commercial lines of business. In partnership with Network Operations leadership, this role ensures contract alignment with regulatory requirements and organizational priorities, supporting the development of high-performing provider networks. This position oversees contracting activities related to hospitals, skilled nursing facilities, home health, durable medical equipment (DME), imaging, and other ancillary services. This individual also provides guidance to internal teams and serves as a subject matter expert on network adequacy, reimbursement models, and market competitiveness. This position will travel to locations within the VIVA HEALTH service area through a reliable means of transportation insured in accordance with Company policy.
Key responsibilities include :
- Lead contract negotiations for acute, post-acute, and ancillary providers ensuring appropriate terms, rate structures, and regulatory compliance.
- Evaluate network gaps and provider performance and work with Network Ops leadership on contracting strategy and prioritizing network development efforts.
- Collaborate with Legal, Finance, Compliance, and Operations teams to finalize agreements that meet internal standards and Centers for Medicare and Medicaid Services (CMS) / state requirements.
- Coordinate internal processes to ensure timely and accurate contract implementation, provider data entry, and system configuration.
- Monitor network adequacy and escalate risks or deficiencies with recommended action plans.
- Serve as a resource to Contracting and Provider Services team members by sharing expertise, standardizing workflows, and ensuring clarity of contracting priorities.
- Build and maintain strong relationships with acute care hospitals, post-acute providers, and ancillary service organizations to promote collaboration and network stability.
- Participate in strategic discussions with providers regarding cost containment, utilization trends, and opportunities for enhanced alignment.
Required qualifications include :
Bachelor's DegreeAt least 3 years in Network Development, Provider Services, or Healthcare ContractingValid driver's license in good standingWillingness to travel and engage in face-to-face provider visits; may include time spent working outside the principal officeStrong understanding of hospital and ancillary provider reimbursement modelsKnowledge of CMS, NCQA, and state regulatory guidelinesExcellent negotiation, interpersonal, and written communication skillsAbility to manage multiple priorities and meet deadlines independentlyStrong attention to detail and organizational skillsProficiency in Microsoft Office applicationsExperience preparing reports and communicating with senior leadershipWilling to submit to vaccine testing and screeningPreferred qualifications include :
Master's degree in Business, Healthcare Administration, or related field5 years in managed care3 years in a supervisory or managerial role