Insurance Contract Manager

Job Description

Job Description

We are a growing Prosthetic and Orthotic organization searching for an experienced Contract Manager based at our Activity and Business Center in Merrillville, IN. This is a full-time position with office hours Monday-Friday, 8 AM-5 PM.

As a key member of Bionics management team, the Contract Manager is responsible for the development, negotiation, and maintenance of all healthcare contracts. Key factors include assertively supporting the sales growth by developing new contracts with payers and expanding services with payers that have existing contracts. The position leads the entire contract process from pre-contract through post-signature phases, and closely collaborates with the sales team and internal departments to ensure staff are informed of new contracts, changes to existing contracts and updates to the medical and billing policies of the payers we serve.

Key Responsibilities:

• Strong knowledge of facility, contracting, and compliance requirement.
• Develop, negotiate and maintain contracts with all payers, insurance companies and government programs. This includes researching territories to identify gaps with our payer base and supporting the expansion into new markets.
• Actively participate in establishing strategic business goals with the Leadership Team.
• Assure contractual arrangements meet financial targets and legal/regulatory compliance requirements.
• Facilitate the approval process of all contract documents from pre-contract through post signature phases.
• Responsible for the accuracy of supporting documentation for contracts and completing documents accurately.
• Develop and maintain processes that provide timely notification of critical contract events. Such as renewals, termination and due dates contained within the agreements.
• Maintain existing relationships with contracted providers. Ensure contractual language is kept current; evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes and reimbursement.
• Direct responsibility for the organization Facility complaisance, including staying current with the current requirements, new facility setup and ongoing maintenance of facility related compliance.

Requirements:

• Minimum of 3 years of relevant experience with hospital, clinic, physician, and/or primary care and health system contracting. Orthotics and Prosthetics is a plus!
• Bachelor's Degree or equivalent experience
• Strong knowledge and understanding of healthcare industry, legal and regulatory requirements
• Willingness to actively participate in all aspects of the contract administrative process.
• Excellent contract negotiation skills
• Knowledge and use of OPIE software preferred but not required.

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