Job Description
job Code
#5193
Title
Healthcare Contract Manager
Date Posted
01/23/2018
Job Type
Direct Hire
Job Location
Massachusetts
Salary
90,000.00 to 115,000.00
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Healthcare Contract Manager

POSITION TITLE: CONTRACT MANAGER, HEALTHCARE

 

POSITION SUMMARY:

  • The Healthcare Contract Manager is responsible for the development, implementation, and ongoing management of managed care contracting for a large hospital and physician practice organization.
  • The contracts contribute to the overall mission, vision and strategy of the organization with a focus on the Initiative for Healthcare Improvement triple aim initiative.
  • The primary responsibilities of the Healthcare Contract Manager include contract administration, review and analysis of contract proposals, development of managed care strategies, and a liaison role to both external and internal customers and other special projects.
  • The Healthcare Contract Manager will report to the Director of Managed Care.

 

POSITION RESPONSIBILITIES:

  • Assist in the development of overall strategy for the managed care activities for the organization
  • Review contract language, rate and fee proposals; complete market analysis comparisons and evaluate proposal and present to senior leadership and membership
  • Participate, develop, maintain and communicate alternative payment methodologies (risk sharing, shared savings, bundle & global payment arrangements, pay for performance programs, etc.)
  • Act as a liaison to internal facility customers, member committees (Board, CAC, CIAC, R&R and PMAG), and external partners (payer contracting and provider relations management)
  • Understand and disseminate healthcare market and industry changes including impacts due to Affordable Care Act, Massachusetts Health Exchange and regulatory requirements and communicate the impact of these changes to the organizational partners
  • Provide supervision and mentoring of respective managed care staff (Senior Contract Administrator & Contract Administrator Associate positions)
  • Follow-up and address with payers the global contracting issues encountered by practices/members. Ensure and interpret payer compliance to contract language and provisions and follow-up on issues as appropriate
  • Develop, review and communicate operational and clinical requirements
  • Assist with pay for performance and bonus program settlement and distribution process

 

POSITION REQUIREMENTS:

  • Bachelor's Degree
  • Hands-on management experience of 25+FTEs
  • PHO, ACO, Hospital & Provider focus/experience
  • 5-8 years of contracting experience in Healthcare, Managed Cared, Payer environments
  • Ability to see the big picture
  • Ability to navigate healthcare environment with key parties
  • Solid ability to do high-level presentations to a variety of audiences
  • Proven ability to negotiate pay rates and fee schedules
  • Knowledge of antitrust laws and regulations
  • Financial, revenue cycle, patient accounts acumen
  • Solid communications and relationship building skills

 

***ALL QUALIFIED CANDIDATES WILL BE RESPONDED TO***