Contract Manager, Florida Healthy Kids

South Florida Community Care Network • Sunrise, FL

35d • Hybrid

About The Position

The FHK Contract Manager is CCP’s primary contact for the Florida Healthy Kids contract. This role leads client communications and governance, interprets and operationalizes contract and amendment requirements, orchestrates cross‑functional deliverables across CCP departments and subcontractors, and ensures audit readiness and timely regulatory submissions. Success in this role is measured by on‑time, accurate reporting; proactive risk escalation; disciplined closure of audit and corrective actions; and positive client relationship outcomes.

Requirements

• Bachelor of Science/Arts in Business or other degree in a related medical or business field or equivalent years of experience is required
• Proficient in Microsoft Word, Excel and PowerPoint
• Knowledge of regulatory environment
• Experience in a high-growth business environment
• Working knowledge of health plan policies and procedures
• Strong analytical and statistical skills
• Ability to work in a fast-paced environment and reprioritize
• Effective problem-solving skills with attention to detail
• Ability to develop, prioritize and accomplish goals
• Strong communication skills (both written and verbal)
• Strong interpersonal skills and high level of professionalism
• Ability to work independently and within a team environment
• Effective active listening and critical thinking skills
• Display a customer service, member-focused orientation
• Must complete a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse.

Nice To Haves

• Business Administration (MBA) or Management is preferred
• Three to five (3 to 5) years in a Managed Care Organization; or other healthcare related field is preferred

Responsibilities

• Establish and maintain collaborative working relationship with assigned client(s) and other key industry stakeholders; serve as primary liaison per contract requirements; provide accurate, timely and concise replies to requested data or reports, etc.
• Primary liaison to provide interpretation and guidance to the organization regarding contract requirements, reporting and administration.
• Owns interpretation of FHK contract requirements; decides intake triage, due‑date commitments, and deliverable acceptance prior to submission to the client.
• Analyze, summarize, and guide the implementation of the annual and interim contract amendments in conjunction with appropriate business owners.
• Ensure effective implementation of new and renewing contracts through communication and coordination with other functional areas.
• Coordinate and compose time-sensitive responses to incoming regulatory requests and inquiries/issues reflective of compliance with contract requirements.
• Coordinate ,lead and participate in desktop audits, regulatory responses and site visits by client(s), as per contract.
• Triage provider inquiries on claims, authorizations, and network status; ensure handoffs and closure.
• Develop and maintain relationships with key internal and external stakeholders to ensure successful collaboration.
• Identify and recommend performance improvement opportunities.
• Report potential risks, non-compliance, or alleged contract violations.
• Engage in Quality Management Initiatives including, but not limited to, material approval, complaints, and grievances, etc. (when applicable)
• Lead weekly meeting with the Client(s).
• Participate in the monthly Joint Operations Committee (JOC) meetings to address performance and FHK contract-related items with CCP’s Subcontractors.
• Lead and monitor CCP Subcontractors Corrective Action Plans for FHK contract-related non-compliance issues.
• Develop and present Quarterly Performance Measures report to client(s) (when applicable).
• Liaison between client(s), providers, and Community Care Plan corporate office.
• Assist providers regarding claims inquiries, authorization status, network status etc.
• Serve as the liaison for resolving issues with Community Care Plan’s internal depts, e.g., Medical Economics, Claims, Provider Operations, IT, UM, etc.
• Travel for FHK Board Meetings, presentations, account satisfaction functions, etc., when required

Benefits

• We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique.
• We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.

What This Job Offers

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