Director, Contract Management - Healthcare

Kaiser Permanente • Atlanta, GA

258d

About The Position

In addition to the responsibilities listed below, this position is also responsible for driving expectations for the development and/or consultation with the legal team of contract templates and language; championing strong communication techniques when responding to inquiries about contract templates and language; leveraging research on contract rates and services to select best service; setting the direction for the development of rate methodology and strategies; evaluating the network composition against regulatory metrics, health plan client requests, and/or clinical access adequacy needs; driving collaboration efforts with various services lines to develop rate/contract strategies to improve access and availability and service delivery expansion; identifying necessary adjustments to contracting strategy and coordinating operations based on federal and state mandates or regulatory requirements; developing best practices for the negotiation and completion of companion agreements, letters of intent, and/or memoranda of understanding; and developing provider programs in Pay for Performance Agreements, Pay for Quality Agreements, Value Based Purchasing Contracts, and Total Cost of Care.

Requirements

• Minimum two (2) years of experience managing operational or project budgets.
• Minimum five (5) years of experience in a leadership role with or without direct reports.
• Bachelor's degree from an accredited college or university AND minimum nine (9) years of experience in health care delivery or operations in a managed care environment, customer relationship management, or a directly related field OR Minimum twelve (12) years of experience in health care delivery or operations in a managed care environment, customer relationship management, or a directly related field.

Nice To Haves

• Contract Management
• Contract Law
• Legal Documentation
• Business Acumen
• Business Planning
• Business Process Improvement
• Written Communication
• Compliance Management
• Applied Data Analysis
• Trend Analysis
• Knowledge Management
• Business Relationship Management
• Consulting
• Interpersonal Skills
• Market Knowledge
• Key Performance Indicators
• Project Management
• Time Management
• Quality Assurance Process
• Computer Literacy
• Presentation Skills
• Health Care Reimbursement
• Training

Responsibilities

• Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others.
• Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement.
• Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs.
• Stays up to date with organizational best practices, processes, benchmarks, and industry trends; shares best practices within and across teams.
• Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives.
• Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.
• Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion.
• Translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies.
• Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues.
• Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources.
• Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.
• Supports continuous improvement efforts by effectively prioritizing risks and encouraging teams to use data-driven approaches when identifying and/or consulting on continuous improvement opportunities across the contract ecosystem.
• Ensures contract commitments are met by evaluating provider operation and management data trends to generate short-term strategies for assessing and improving provider compliance.
• Drives systems to address and resolve complex issues related to provider compliance with contract terms and conditions.
• Implements systems and strategies to ensure provider compliance with state and federal regulations as well as KP policies and procedures.
• Reviews and negotiates complex contracts and consulting with Provider Systems Administration (PSA) or its equivalent as needed to ensure proper contract interpretation and operational readiness.
• Supports contract strategy development by driving the implementation of long-term strategies that improve the quality of and access to patient care while managing outside service costs.
• Drives outreach efforts with potential partners/alliances to create relationships that fill service gaps or decrease costs in current service offerings.
• Develops, maintains, and manages trusted and strategic partnerships with networks of providers to understand their unique challenges, goals, and future directions.
• Acts as a trusted representative for networks of providers and KP by implementing communication strategies and driving transparency around issues and areas for improvement.
• Contributes to provider satisfaction by leveraging advanced knowledge of provider/contract operations to advise the department on the consultation of highly complex issues.

What This Job Offers

• Career Level: Senior
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree