Manager of Contract Compliance

Harbor Health Services, Inc.•Boston, MA

11h

About The Position

Harbor Health Services is an innovative, growing, mission-based organization that lives, serves and collaborates with our community members to achieve our mission to help individuals reach their full potential through access to local, affordable services that promote health. Harbor provides medical, behavioral health, dental, and support services to more than 34,000 patients in Boston, the South Shore, and Cape Cod. Harbor Health also operates two Programs for All-Inclusive Care for the Elderly in Mattapan and Brockton, providing comprehensive healthcare, transportation and social services for more than 580 frail elders who continue to live with dignity and independence in the community and a Woman, Infants and Children (WIC) Nutrition Program. To help further the mission of Harbor, we are looking for an talented Manager of Contract Compliance for our Health Centers and Elder Service Plan. Role: The Manager of Contract Compliance, oversees the full lifecycle of contract development, execution, and management across corporate operations, Community Health Centers (CHC), and the Elder Service Plan (ESP). This role is responsible for standardizing and centralizing contracts, affiliation agreements, and Business Associate Agreements (BAAs) within a contract management system, ensuring accuracy, accessibility, audit readiness, and compliance with federal and organizational requirements, including HRSA, HIPAA, and CMS regulations. The Manager leads document control practices, supports academic affiliation partnerships, and ensures contracts and Memoranda of Understanding (MOUs) clearly defines scope and compliance expectations. Additionally, it drives ESP network contracting strategy through vendor sourcing, negotiation, performance monitoring, and compliance oversight, while collaborating cross-functionally to resolve issues, and maintain a high-performing, compliant provider network aligned with operational, financial, and clinical goals.

Requirements

Bachelor’s degree in related field required; Master’s degree preferred
5-7 years of related experience in a managed health care environment, with a thorough knowledge of the health care market and the needs/concerns of health care providers
Effective communication and presentation skills, both verbally and in writing
Acumen to negotiate new vendor contracts in coordination with internal stakeholders including Marketing, Finance, Legal and Compliance
Strong analytical skills
Contract negotiation experience is desirable, with ability to understand and interpret all aspects of a contract: financial, legal, and operational with emphasis on implementation of contract terms
Proven time management and organizational skills, and ability to work independently and prioritize multiple demands
Excellent computer skills, including proficiency in Office 365 Word, PowerPoint Excel and Teams.
Must be able to travel in a timely manner to Harbor Health sites, vendor sites and other service provider sites in ESP’s service area as needed.

Nice To Haves

Master’s degree preferred
Contract negotiation experience is desirable, with ability to understand and interpret all aspects of a contract: financial, legal, and operational with emphasis on implementation of contract terms

Responsibilities

Responsible for developing an executive annual contractor audit and compliance work plan to ensure adherence to federal, state and regulatory bodies. Issues and monitors corrective action plans as needed and coordinates terminations resulting from violation of laws, compliance, and contractual terms.
Leads efforts to standardize, streamline, and centralize all contracts, affiliation agreements, and BAAs within HHSI’s contract management software program for Corporate, ESP and the Community Health Centers.
Ensures all documents are accurately uploaded, categorized, and maintained to support accessibility, audit readiness, and reporting needs.
Develops and enforces document control practices, including versioning, renewal alerts, and periodic audits to ensure completeness and accuracy of the contract repository.
Leads comprehensive oversight of the end-to-end contracting process across both Corporate and Community Health Center operations.
Ensures all contracts are developed, reviewed, approved and executed in accordance with organizational policies and federal and state requirements, including those set forth by the Health Resources and Services Administration (HRSA).
In conjunction with the VP of Compliance and Risk Management, maintains an accurate and complete Form 5A based on Contracted Relationships per HRSA.
Oversee the development, review and execution of Business Associate Agreements (BAAs) to ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations.
Collaborates closely with the Human Resources department to develop, review, and maintain student affiliation agreements with academic institutions.
Leads the creation, review, and ongoing monitoring of Memoranda of Understanding (MOUs) for the Community Health Centers.
Ensures all MOUs and contracts clearly define scope of services, roles and responsibilities, performance expectations and compliance obligations.
Leads ESP network contracting strategies designed to balance enrollment, operational, financial and clinical goals.
Evaluates use of contracted services and identifies areas of network deficiencies and increased service demand for network expansion.
Sources, develops, negotiates, executes and manages network provider and vendor contracts based on solid knowledge of reimbursement methodologies, system and operational constraints and CMS regulations.
Serves as the primary point of contact and champion for the network and ESP community as it relates to contract maintenance and management, operational, claims submission and implementation issues and questions.
Collaborates with other departments to research and resolve contractual issues.
Coordinates activities and documents required for one-time authorizations (MOUs) to ensure prompt vendor payments.
Maintains accurate list of contracts and contracted personnel required by the CMS audit; validates credentialing of contracted provider when required.
Understands and shares performance/quality metrics in comparison to the network; analyzes, researches, and interprets results, variances, and trends and prepares and communicates analysis and recommendations verbally and in writing to the network and ESP management.
Ensures compliance with CMS regulations and requirements through a contract oversight policy that aligns with other internal policies and procedures.
Maintains regular and punctual attendance.
Performs other related duties as assigned.