Contract Manager

US-NE-Omaha
2 weeks ago
Job ID
2017-2003
# of Openings
1
Category
Compliance

Overview

The overall purpose of this job is to ensure consistent management of all proposals and contracts for Immanuel, Immanuel Communities, Immanuel Long-Term Care and the Immanuel Pathways PACE program. The primary responsibilities of this job include providing oversight of the contract management process, as well as development of specific standards for bidding and submission, contract negotiations and document management. Serves as the point of contact for customers on contractual matters. Ensures a contract management process is established and managed effectively. Provides timely review and approval/reconciliation of any issues and/or variations concerning the contract. Requires close collaboration with various departments, including but not limited to compliance, clinical operations, project management, account management, business operations and finance. Supports and lives out Immanuel’s Mission and CHRIST Promises.

Responsibilities

Approx. Time Requirement

Key Responsibilities and Duties of the Job

80%

Administration

  • Establishes and monitors the contract management process.
  • Oversees organizational contract development and management activities and enforce organizational principles of integrity and compliance.
  • Ensures contracts and proposals are properly entered into organizational databases and securely maintained.
  • Maintains list of current vendors, including contact names and file of work utilized.
  • Develops standards for contracts, including presentation of budget, payment terms, general language and provisions.
  • Performs appropriate clinical, administrative and operational research to support proposal and contract development.
  • Conducts contract strategy meetings to identify issues and client requirements, facilitate pricing discussion and obtain senior management input on timelines and deliverables.
  • Drafts contractual provisions based on strategy discussion, senior management input and organizational needs and expectations.
  • Assures accuracy and appropriateness of contract text and attachments.
  • Interfaces with insurance companies regarding adequacy of coverage and purchasing needs.
  • Serves as primary organizational contact and maintains positive relationships with vendors.
  • Solicits bids for potential vendors when appropriate.
  • Engages relevant stakeholders in negotiation decisions involving legal, legislative and/or regulatory requirements, contract standards and cost targets.
  • Develops and executes negotiation strategies that minimize potential losses and benefit the organization’s financial performance.
  • Maintains deadlines on deliverables and communicates on an ongoing basis with business partners and internal clients about contractual issues.
  • Ensures contracts are reviewed on a regularly scheduled basis.
  • Assesses contracting software product options as applicable.
  • Responsible for all aspects of hospital and physician network development and management as well as developing and recommending policy changes related to provider recruitment and contracting.
  • Recruits and negotiates contracts with specific providers within operational counties to meet company requirements.
  • Oversees training and communication for network providers and acts as a liaison with the provider community.
  • Ensures compliance with pricing guidelines established by Immanuel.
  • Ensures provider contracting is consistent with claim payment methodologies.
  • Ensures that non-standard contract elements are communicated to appropriate departments and obtains approval prior to submission to provider.
  • Responsible for the accuracy and timely management of all provider contracts.
  • Responsible for implementation of electronic strategies for provider network to include increasing electronic claims submission and implementation of improved processes that result in increased auto-adjudication of claims.
  • Establishes a priority list of geographic locations and types of providers to be added to the network in concert with Immanuel departments.
  • Works with departments to retain network providers at risk for termination.
  • Creates and maintains docket entries for the contract management system relating to on-going deadline dates for assigned business service line.

10%

Compliance

  • Responsible for running the Office of Inspector General (OIG)  monthly report for the appropriate business lines.
  • Reviews contractual performance of both parties to ensure compliance with terms and to identify conflicts or changes requiring resolution at contact renewal.
  • Follows all Immanuel policies, procedures and OSHA safety guidelines.
  • Protects privacy and maintain confidentiality of all company procedures, results and information about employees, participants and families.

10%

Other

  • Perform other duties as assigned or requested.
  • Participates in continuing education classes and any required staff and training meetings.
  • Maintains professional affiliations and any required certifications.

 

 

Qualifications

Education-

  • Bachelor’s degree is required in applicable field of study such as health care administration, health care management or business administration.
  • Master’s degree or Juris Doctor preferred.

Experience-

  • Three (3) to five (5) years of experience in contract negotiation, procurement and management as well as provider contracting/reimbursement in a health care organization required.
  • Two (2) to four (4) years of supervisory/management/leadership experience is desired, preferably in a managed care setting. 
  • One (1) to three (3) years of Medicaid experience preferred.

Other Requirements-

  • Must have a valid driver’s license, proof of insurance and have means of transportation.
  • Must have medical clearance for communicable disease and up-to-date immunizations.

 

KSA- Knowledge Skills and Abilities-

  • Excellent negotiating and persuasive skills, both in one-on-one and group situations.
  • Proficiency in utilizing and interpreting financial models and analyses.
  • Proven experience and basic computer proficiency (internet, email, Microsoft Office).
  • Skills in analyzing situations accurately and taking effective action as work methods and procedures in this position are generally undefined.
  • Skills in establishing and maintaining effective working relationships with supervisor, employees, internal departments and external stakeholders.
  • Skills in exercising a high degree of initiative, judgement, discretion and decision-making to achieve organization objectives.
  • Skills in general direction toward accomplishment of program/project objectives. Must utilize available resources to accomplish end result.
  • Skill in organizing work, making assignments and achieving goals and objectives.
  • Skilled in attention to detail as work is highly diverse and has a broad range of activities that require a substantial depth of analysis.
  • Skilled in exercising judgement in developing, applying, interpreting and coordinating departmental policies and procedures.
  • Strong verbal and written skills and ability to convey complex information in a way that others can readily follow.
  • Ability to assume responsibility and exercise authority over assigned work functions.
  • Ability to collaborate with supervisor to set objectives and determine methods for successful achievements of goals.
  • Ability to organize and integrate organizational priorities and deadlines.
  • Ability to research and apply knowledge of regulatory/compliance guidelines to meet objectives.
  • Ability to systematically analyze complex problems, draw relevant conclusions and implement appropriate solutions.
  • Ability to think creatively as work involves continuing changes in program, technological development, unknown occurrences or conflicting conditions requiring extensive mental effort and creativity.

 

 

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