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Contract Manager opportunity available with a growing home healthcare company - Relocation assistance available! (onsite)

This Jobot Job is hosted by: Renee Brooks
Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.
Salary: $80,000 - $110,000 per year

A bit about us:

We are a growing home healthcare service agency in search of a Contract Manager to join our growing team.

Why join us?

We offer a competitive salary, relocation assistance, and a full benefit package.

Job Details
  • Lead, develop and identify negotiation strategies for value-based contract negotiations with payors, while working collaboratively with internal key stake holders to execute and manage such arrangements.
  • Remain current on the licensure requirements for each of the state
  • Strategically develop and implement Managed Care, IPA, and Payor Contracts on a regional, and local level for multiple lines of business including commercial and governmental products.
  • Review and analyze contract language and reimbursement terms in existing and potential managed care agreements and make recommendations of any modifications required for the benefit of the organization.
  • Cultivate relationships and maintain strong communications with health plans and payors.
  • Investigate and evaluate payor markets in different states (payor mix, reimbursement issues, and state regulatory statutes) and provide recommendations to adapt to a changing health care industry.
  • Develop and analyze large and complex data sets for the creation of financial rate models, make proposal recommendations and take the lead in negotiating/renegotiating and implementing rates and terms for health plan contracts, ensuring key operational and financial objectives are met.
  • Prepare financial reports to review, assess and analyze utilization trends and overall financial performance of contracts, and identify improvement opportunities with rates/contract language and develops plans and actions to carry out improvements.
  • Document, organize and coordinate payor enrollment requirements and assure that an appropriate knowledge base is maintained for use in enrolling all affiliated medical practices.
  • Perform continuous monitoring of the payor enrollment process to ensure compliance with standards
  • Produce reports and review application tracking to track progress of onboarding and payor enrollment.
  • Review onboarding list weekly to identify and address obstacles in onboarding and attend weekly onboarding calls.
  • Review and refine workflows to ensure timely payor enrollment and resolution for provider related claims denials to ensure in network reimbursements.
  • Provide guidance, support, and recommendations to upper management regarding department issues and resolutions.
  • Perform research into specific issues as directed by Management for timely resolution.
  • Remain current on industry trends, payor changes and market conditions as they relate to all plans.

The ideal candidate will demonstrate hands-on, in-depth knowledge of provider onboarding, delegated credentialing, Medicaid payor requirements, and architecture regarding the necessary requirements. This role is ideal for the self-starter who can pivot to resolve issues creatively and tactfully. The individual will also demonstrate a high level of organization skill and interact positively with all members of the Revenue Cycle team.
  • Minimum BA/BS in Business Administration, Healthcare Administration degree; advanced degree preferred.
  • Minimum of three (3) years of prior occupational and supervisory experience with provider enrollment and credentialing to be successful in the role. Previous management experience is a definite plus. (Preferred) 5 years’ experience negotiating and managing contracts within the health care industry working on either the health plan or provider side.
  • Demonstrated strong knowledge of managed care regulations, state legislation, and laws related to health care and health care operations, as well as value based and analytical models.
  • Strong negotiation and interpersonal skills; strong written, verbal, and analytical skills; motivated and a proactive strategist with the ability to adhere to deadlines; work to “get the job done”. Must be a “self-starter” with the ability to multi-task.
  • Professional business sense and presentation skills; strong knowledge of reimbursement methodology types (i.e., case rates; unit rates, fee for service etc.).
  • Proficient in creating and utilizing MS Excel spreadsheets and all other MS Office programs.

Interested in hearing more? Easy Apply now by clicking the "Apply Now" button.

Job country: United States

City: Tallahassee

Category: Business Operations Specialists, All Other

Location: Tallahassee, FL, United States

Job posted 2022-06-04

This job is expired

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