Senior, Manager, Provider and Facility Contracting

HMSA • Honolulu, HI

2d • Hybrid

About The Position

This role is responsible for leading and managing the contracting function within Provider Services. The position oversees the work of employees in the CFR department and external contracted vendors. Key responsibilities include providing direction and guidance to staff, managing contract negotiations, coordinating training, and ensuring legal and regulatory compliance. The role also involves building and leading a high-performing team, managing execution of work, and overseeing CFR operations, including day-to-day management, personnel oversight, performance management, hiring, and contract management to mitigate risk and ensure business continuity. Additionally, the position is responsible for participating in the development, support, and implementation of HMSA's overall provider strategy, including contracting strategy for hospitals and facilities. This involves close participation in corporate strategy initiatives, ensuring staff alignment, and identifying the need for new contracts and strategies. The role also focuses on developing and maintaining partnerships with strategic provider partners, conducting contract negotiations, and representing Provider Services on cross-functional teams.

Requirements

• Bachelor's degree and six years of related work experience, or an equivalent combination of education and work experience.
• Two years of previous management/supervisory experience.
• Experience with a highly regulated industry.
• Experience negotiating contracts and/or vendor/contract management.
• Communicate clearly and concisely, both verbally and in writing.
• Establish and maintain effective working relationships with those contacted in the course of work.
• Excellent interpersonal skills.
• Strong analytical skills.
• Strong leadership skills.
• Strong planning and organization skills.
• Excellent supervisory/management skills.
• Excellent leadership skills.
• Basic knowledge of Microsoft Office applications (Word, Excel, Outlook, and Power Point).

Responsibilities

• Manage CFR Team: Provide direction and guidance to staff, hold staff accountable, review and provide guidance for contract negotiations, provide or coordinate training, work with other HMSA departments for compliance, build and sustain a high-performing team, attract and retain talent, develop people, provide direction, delegate, remove obstacles, plan and prioritize work, identify development areas for direct reports, assign tasks, review and monitor performance.
• Oversee CFR operations: Manage day-to-day operations, oversee personnel, develop and communicate performance measures, conduct reviews, determine salary changes, hire and dismiss employees, manage contract management and provider contracting operations (accuracy of eVIPs contract record and data entry, system testing, accurate payment outcomes/terms, contract negotiation schedules/timelines, contract timeline ticklers, contract oversight and compliance).
• Compliance: Ensure provider contracts and policies are administered properly by HMSA, including alignment of contractual terms with claims processing, utilization management, and appeals. Coordinate internally with other HMSA departments. Ensure contractual compliance to HMSA business, rules/regulations, laws, and program requirements.
• Provider Strategy: Participate in the development, support, and implementation of HMSA's overall provider strategy, including contracting strategy for hospitals and negotiated and facility contracting. Participate in corporate strategy initiatives (ACOs, value-based arrangements, payment transformation, strategic vendor relationships). Ensure staff are informed and aligned with corporate strategy. Identify the need for and coordinate the development of new contracts and strategies.
• Provider Partnership: Develop and maintain partnerships with strategic provider partners. Conduct provider contracting negotiations. Develop and maintain positive working relationships with hospital administrators, financial management staff, physician organization leadership, and quality improvement staff. Represent Provider Services on cross-functional projects and teams. Work directly on corporate initiatives, provide guidance on contract matters, and provide training on contracting practices and procedures.
• Perform all other miscellaneous responsibilities and duties as assigned or directed.

What This Job Offers

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