Senior Contract Manager - Managed Care

Cleveland Clinic

1d•Remote

About The Position

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world. As a Senior International Contract Manager, you will negotiate contracts on behalf of CCF within an assigned business area, evaluate new business opportunities, and manage the administrative, legal, operational, and financial aspects of contract negotiations. In this role, you will contribute to contracting strategy development, including business planning and implementation. A caregiver in this position works remotely from 8:00 a.m. -- 5:00 p.m. This role is required to meet with the team annually in Cleveland for a half-day, on-site meeting. Seeking candidates who reside in Ohio, Florida or Nevada. Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Headquartered in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 70,800 employees worldwide represent 140 medical specialties and subspecialties. Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 19 hospitals, more than 220 outpatient facilities, and locations in southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England.

Requirements

Bachelor’s Degree in healthcare, finance, marketing or related field and five years of experience in contract management OR High School Diploma / GED or equivalent and 9 years of related experience
Strong background involving managed care contracting with health systems to include hospital, professional, ancillary services
Experience with Fee for Service and Value Based negotiations for Commercial, Medicaid, Medicare Advantage and Marketplace plan types
Understanding of Revenue Cycle and Managed Care Business Operations
Managed care experience
Experience across multiple service lines (e.g., heart and vascular, transplant, women’s health)
Health system–based managed care contracting experience
Experience with claims payment methodologies and operations
Hands-on experience negotiating and managing health insurance contracts
Working knowledge of contemporary healthcare policies, practices, operations and reimbursement methodologies
Knowledge of physician practice management, hospital administration and operations
Rate and contract negotiation and influencing skills

Nice To Haves

Master's Degree
10 years of experience in contract management
Certified Public Accountant (CPA) or Certified Management Accountant (CMA) (for Finance-related contracts)
Strategic contracting experience
Experience with transplant and high-cost drug negotiations

Responsibilities

Negotiate contracts on behalf of CCF within assigned business area.
Evaluate new business opportunities.
Manage administrative, legal, operational and financial issues related to contact negotiation.
Participate in contracting strategy development including business planning and implementation issues.
Prepare, coordinate and manage contract negotiation process.
Identify and evaluate opportunities and financial terms for assigned contracts.
Assess potential legal risk in the context of contract provisions.
Develop appropriate legal and financial contract language.
Coordinate and participate in legal review.
Prepare responses, letters of agreement and key contract provisions.
Prepare and implement strategies for business growth.
Identify and target specific areas for development.
Initiate and develop relationships.
Track history and progress.
Serve as the principal contact for third-party payers and internal clients in the development, negotiation and review of proposed agreements.
Review contractual performance of both parties to ensure compliance with terms and to identify conflicts or changes requiring resolution at contract renewal.
Develop methodology and review models that consistently and objectively evaluate the financial impact of proposals.
Update methodologies as contract issues change.
Prepare responses to Request for Proposals (RFP) as required.