Contract Manager

JOB SUMMARY

This position is responsible for procuring, negotiating, executing and monitoring of the PACE contract providers. Promotes professional working relationships with both internal and external customers. Adheres to and supports all organizational policies and procedures and standards. Promotes teamwork!

ESSENTIAL DUTIES AND RESPONSIBILITIES

ORGANIZATIONAL (CORE RATING FACTORS):

• Ensure discretion with confidential information.
• Maintains courteous, helpful and professional behavior on the job. Will support the success of the entire team by promoting a collaborative work environment.
• Adheres to all Policies and Procedures, Safety Policies and Procedures and OSHA safety guidelines.
• Consistently contributes to problem-solving and cooperates with identified resolutions.
• Must demonstrate regular attendance and punctuality.
• Brings issues and process improvement ideas to the attention of the Supervisor.
• Maintains verbal and written skills required for the position.
• Attends meetings and participates in committees as required.
• Completes annual trainings as required.

• Adheres to Company Dress Code Policy.
• Demonstrates appropriate level of time management in support of co-workers and the entire team.

DEPARTMENTAL (JOB SPECIFIC TASKS):

• Conducts initial meetings with possible providers to educate them about contractual process.
• Conducts appropriate follow-up with pending providers to ensure timely implementation of contracts.
• Develops contractual relationships with service providers, such as negotiating rates and draft contract agreements. Negotiates effective contracts with both professional and institutional vendors on behalf of the PACE organization, and amends contracts, as needed.
• Responsible for new contractor initial provider orientation training for all contracted providers to ensure contract compliance and adequate education of the contractor.
• Ensures contract compliance with State and Federal regulations.
• Meets with Contracted Community Providers (CCPs) for Periodic Observation and Review per CMS regulation timeframes and conducts follow up, as necessary, if Corrective Action Plan is warranted.
• Responsible for establishing and maintaining complete Contracted Community Provider (CCPs) files and ensuring compliance and accuracy, including complete monthly OIG and EPLS documented checks and follow up.
• Organizes, leads, and documents minutes and follow-up for all contracted Skilled Nursing Facilities, Assisted Living Facilities, and outside Home Health agencies every quarter.
• Credentialing of individual contract entities every three years.
• Provides update PACE Policies to contracted providers annually.
• Conducts Provider Survey every two years, with results presented to Vice President with recommendations based on any trends. Follow up with the IDT and contract providers on any issues that need to be addressed as a result of the survey.
• Develops provider network to meet PACE participant needs.
• Ensures that the provider network listing is always current and accurate, both in terms of the website and the Provider List given to new and current enrollees.
• Responsible for tracking appeals from initiation to completion based on CMS guidelines prescribed in PACE regulations. Ensures a rigorous internal review is completed, with any external reviews by independent third party reviewers coordinated by the Contract Liaison, if applicable. Responsible for all documentation related to specific appeals made by PACE participants.
• Identifies, analyzes, and resolves work problems in conjunction with PACE management as necessary.

• Follows all Policies, Standard Operating Procedures and OSHA safety guidelines.
• Additional responsibilities will be added at managers discretion, as career growth opportunities and responsibilities are constantly arising in our flexible and start-up environment.

QUALIFICATIONS

• Bachelor's Degree in a related field is preferred.
• Experience negotiating and executing contracts preferred.
• Minimum of one year of experience with frail, elderly, or disabled population.
• Must have excellent written and verbal communication skills and demonstrate the ability to interact clearly and effectively with both internal and external customers.
• Skilled in preparing and maintaining electronic records, writing reports using Word programs, and responding to correspondence.
• Skilled in establishing and maintaining effective working relationships with participants, co-workers, vendors, medical staff, and the public.
• Must submit to and pass a pre-employment drug/alcohol screening and criminal background check.
• Must have a current Driver's License and driving record must be in compliance with Company policy. Must maintain current automobile insurance. You will be required to drive your own car for company business. PACE reimburses for mileage.
• Must be free of communicable diseases that can be readily transmitted in the workplace. TB test is required within first 7 days of employment. Hep B vaccinations are offered but not required.
• Operates in full compliance with all applicable federal, state and local fire, health, safety, sanitation, Emergency procedures and other Standards prescribed in law or regulations.

ABOUT PACE of West Baltimore

PACE of West Baltimore (Program of All-Inclusive Care for the Elderly) is an integrated, home and community-based care model designed to help seniors maintain their independence and remain part of their communities for as long as safely possible. We care for our participants through a harmony of center-based services and personalized in-home care, spanning clinical, behavioral, and social services.


PACE is a proven, cost-effective care model, saving states an average of 13% versus other Medicaid services, including nursing homes and community-based waiver programs. PACE of West Baltimore's unique approach to PACE is enhanced by our deep expertise in in-home care, clinical geriatrics, data analytics, and virtual care technology, all for the purpose of improving the health and quality of life of our patients.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. PACE of West Baltimore is an Alcohol/Drug/Smoke-Free Workplace

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Physical Requirements: While performing the duties of this job, the employee is frequently required to stand; walk; lift heavy objects; sit; use hands to finger, handle or feel objects, tools, or controls; talk, see, hear, and smell. Requires full range of body motion, manual and finger dexterity, and eye-hand coordination; requires the ability to use department equipment, to communicate effectively; The employee is occasionally required to reach and stretch with hands and arms; climb or balance; and stoop, kneel, crouch, or crawl. The employee may be required to endure extremes in temperature and may work in hazardous environments where personal protective equipment is required. Requires the ability to lift/carry up to 50 pounds and push or pull objects exceeding 150 pounds, using appropriate body mechanics.
• Visual, Hearing and Communication Requirements: Requires corrected vision and hearing to within normal range, with or without reasonable accommodation. Must be able to communicate effectively in verbal and written form with all levels of personnel within and outside of the organization.
• Pressure Factor: Requires working under stressful conditions. Moderate pressure to meet scheduled and recurring deadlines.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Environmental Conditions: Working conditions may be noisy with fluctuating indoor temperatures. Must have the ability to work under moderate pressure in order to meet scheduled appointments or deadlines while dealing with frail, disabled and/or confused participants/clients. Subject to individuals who may have the potential for physical or verbal aggression. May be exposed to a risk of bodily injury through contact with moving instrumentation, toxic substances, medicinal preparations, bodily fluids, communicable diseases, and other conditions common in a clinic environment. Subject to unpleasant odors.