Contract Manager

Unified Women's Healthcare

14d

About The Position

Unified is a nationwide community of providers, operations specialists and thought leaders who look for the greatest opportunities to impact every woman’s health, at every stage of their journeys. We are unparalleled in our scale and ability to adapt to address unmet and underserved needs. Through 815+ clinics, 23 IVF labs, nationwide telehealth capabilities and targeted case management, our 2,700+ independent, affiliated providers deliver comprehensive women’s health services and continuously work to implement methods and develop techniques or platforms that improve the healthcare experience. We remain focused on enabling the discovery of new ways for our affiliated providers to deliver the high-quality care experience women deserve, in the ways they most wish to receive it, and collaborate across our community to make our vision a reality. The Contracting Manager is responsible for managing contracts, administrative and technical, through development, negotiation, implementation of terms, and monitoring contractual agreements. The position supports the entire contract process and closely collaborates with internal departments to ensure staff are informed of new contracts, changes to existing contracts, and updates to the medical and billing policies of the payers. The Contracting Manager will report to the Director, National Managed Care Contracting.

Requirements

• Bachelor’s Degree or equivalent experience required.
• 3+ years’ contracting experience with hospital, clinic, physician, and or health system required.
• Competent in healthcare industry, legal, and regulatory requirements required.
• Excellent contract negotiation skills.

Nice To Haves

• Previous experience in IVF and Infertility medicine.
• 1+ year experience with medical insurance company, MSO, IPA, TPA, preferred.

Responsibilities

• Perform full life-cycle Contract Management for a large portfolio of high value contracts.
• Provide technical expertise in developing, organizing, and processing contracts and facilitate the approval process of all contract documents from pre-contract through post signature phases.
• Develop and maintain periodic, e.g., bi-weekly, reports on the status of all contracts.
• Collaborate on new practice transitions by researching territories to identify gaps with our payer base and supporting the expansion into new markets. Make recommendations regarding participation or non-participation with new or existing agreements.
• Review, interpret, analyze, manage, and negotiate complex agreements and resolve contractual issues.
• Adhere to all established contracting language and financial guidelines and parameters.
• Maintain and track financial performance for contracts and contract status. Monitor and coordinate financial analysis of payer contract performance and modeling projections.
• Utilize MedTrainer, Contract Works or other electronic tracking platform for repository, data collection, and reporting.
• Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes.
• Develop and maintain processes that provide timely notification of critical contract events (e.g., renewals, termination and due dates contained within the agreements).
• Maintain existing relationships with contracted providers. Ensure contractual language is current; evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes and reimbursement.
• Represents the organization in establishing business relationships with payers. Utilize communication and organizational skills to work collaboratively and credibly with payers to achieve common objectives.
• Collaborate with staff and contractors to ensure compliance with applicable laws and contract terms.
• Develop and maintain productive working relationships with project team members, partners, clients, vendors, and other key stakeholders.
• Maintain knowledge of federal, state, and county policies and legal requirements.
• Assist in producing and disseminating contract information to all relevant departments; assists to identify and resolve problems that arise with contracts including billing, claims payment, scheduling, registration, credentialing, service development, and care management, noncompliance.
• Respond to third party payers, employers, internal staff and physicians in day-to-day customer service relations and problem resolution.
• Collaborate with operational departments, identify, and implement appropriate changes in operating procedures and systems that might be required to accommodate payer contracts.
• Incorporate strategic business goals as presented by the CCRM Senior Leadership Team.
• Coordinate and communicate contractual terms to the billing department; ensure staff is informed of changes in medical policy & billing policies.
• Effectively and professionally, represent CCRM to the payer, provider, and patient community.
• Other duties as assigned.

Benefits

• Medical, dental, and vision plans, fertility benefits, and supplemental insurance options.
• Vacation, personal days, and paid holidays to help you recharge.
• 401(k) with employer contribution, plus Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs).
• Short- and long-term disability, paid parental leave, basic life insurance, and optional additional coverage.
• Employee Assistance Program, commuter benefits, pet insurance, and identity theft protection.
• Opportunities and resources to support your career growth.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager