Managed Care Contract Manager

Description


Position at BayMark Health Services


Full Time - Contract Manager

Responsible for managing and coordinating payor contracts. This includes internal review, approval, execution, tracking, submission to payor, implementation support, and inventory. This does not include negotiating payor contracts with commercial plans. Familiar with the field team's concepts, practices, and procedures. Performs a variety of tasks in collaboration with Revenue Cycle, Accounting Department, Payor Relations, and Leadership. Leads and directs the work of other contracting team members. Works to enhance the efficiency of the overall contract needs of the company.

Responsibilities

• 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 (e.g., renewals, termination and due dates contained within the agreements).
• Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes.
• Forecast upcoming renewals; ensure renewal contracts documents are received, routed through the internal approval process, submitted to the respective payor entity.
• Responsible for tracking documents and maintaining inventory.
• Ensure proper documentation and staff follow SOPs.
• Assists with the development and evolution of the team's strategic direction, annual goals and objectives; recommends new processes and changes for increased productivity.
• Consults management and initiates changes in procedure with approval. Acts as a resource in the development of contracting protocols.
• Establish and maintain strong working relationships with key internal business partners.
• Actively participate in establishing strategic business goals with the Leadership Team.
• Participate in network provider meetings and/or workgroups as necessary.
• Manage multiple projects, collect and analyze data and disseminate to appropriate departments as necessary.
• Coordinate contract language change requests to ensure template accuracy and utilization.
• Will delegate, manage workload to the team proportionately. 16. Train and follow-through for team member to meet goals. NSC - Contract Manager, Job Description Page 2
• Keep positive morale in the department.
• Develop and maintain periodic, e.g., bi-weekly, reports on the status of all contracts.
• Assist with all contracting administration and projects, as needed.
• Create and maintain all SAM.gov registrations.
• Remain composed in a stressful environment and deal with frequent deadlines and multiple priorities.
• Conduct all business activities in a professional and ethical manner adhering to medical necessity compliance and financial compliance.
• Comply with BayMark policies and procedures, Compliance Policy and Code of Ethics.
• May perform other duties as assigned.

Minimum Qualifications

• Must be at least 18 years of age.
• Previous medical industry payor contract experience required (2+ years).
• Prior management experience (5+ years).
• Must have strong working knowledge in contracting with an emphasis on government and commercial payors for all lines of business.
• Candidates experience in medical terminology as it relates to BayMark lines of business is preferred.
• Working knowledge of MCO contracting and grant requirements.
• Excellent verbal and written communication skills.
• Compliance with all HIPAA policies.
• Proficient with Microsoft Office to include Word, Excel and PowerPoint.
• Ability to develop, prioritize and accomplish goals.
• Detail oriented.
• Strong interpersonal skills and high level of professionalism.
• Effective problem solving skills with attention to detail.
• Ability to work independently and within a team.
• Excellent leadership skills and experience leading teams through projects and meeting goals timely with positive outcomes as a team.
• Ability to create and maintain excellent working relationships.
• Compliance with accepted professional standards and practices.
• Satisfactory references from employers and/or professional peers.
• Satisfactory criminal background check.
• Satisfactory drug screen.

What We Offer:

• Competitive compensation package
• Opportunities for professional development and career growth
• A supportive team culture where your contributions make a real impact
• Work with senior executives and hiring teams to shape the future of our workforce

Here is what you can expect from us:

BayMark Health Services, a progressive substance abuse treatment organization, is committed to the highest quality of patient care in a comfortable outpatient and inpatient clinic setting. Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life.


BayMark Health Services is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws.