Senior Contract Manager

Role Description

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world.

As a Senior International Contract Manager, you will:

• Negotiate contracts on behalf of CCF within assigned business area.
• Evaluate new business opportunities.
• Manage administrative, legal, operational and financial issues related to contract negotiation.
• Participate in contracting strategy development including business planning and implementation issues.
• Prepare, coordinate and manage contract negotiation process.
• Identify and evaluate opportunities and financial terms for assigned contracts.
• Assess potential legal risk in the context of contract provisions.
• Develop appropriate legal and financial contract language.
• Coordinate and participate in legal review.
• Prepare responses, letters of agreement and key contract provisions.
• Prepare and implement strategies for business growth.
• Identify and target specific areas for development.
• Initiate and develop relationships.
• Track history and progress.
• Serve as the principal contact for third-party payers and internal clients in the development, negotiation and review of proposed agreements.
• Review contractual performance of both parties to ensure compliance with terms and to identify conflicts or changes requiring resolution at contract renewal.
• Develop methodology and review models that consistently and objectively evaluate the financial impact of proposals.
• Update methodologies as contract issues change.
• Prepare responses to Request for Proposals (RFP) as required.

Qualifications

• Bachelor’s Degree in healthcare, finance, marketing or related field and five years of experience in contract management OR High School Diploma / GED or equivalent and 9 years of related experience.
• Strong background involving managed care contracting with health systems to include hospital, professional, ancillary services.
• Experience with Fee for Service and Value Based negotiations for Commercial, Medicaid, Medicare Advantage and Marketplace plan types.
• Understanding of Revenue Cycle and Managed Care Business Operations.
• Managed care experience.
• Experience across multiple service lines (e.g., heart and vascular, transplant, women’s health).
• Health system–based managed care contracting experience.
• Experience with claims payment methodologies and operations.
• Hands-on experience negotiating and managing health insurance contracts.
• Working knowledge of contemporary healthcare policies, practices, operations and reimbursement methodologies.
• Knowledge of physician practice management, hospital administration and operations.
• Rate and contract negotiation and influencing skills.

Requirements

• Master's Degree (preferred).
• 10 years of experience in contract management (preferred).
• Certified Public Accountant (CPA) or Certified Management Accountant (CMA) (for Finance-related contracts) (preferred).
• Strategic contracting experience (preferred).
• Experience with transplant and high-cost drug negotiations (preferred).

Benefits

• Ability to communicate and exchange accurate information.
• Ability to perform work in a stationary position for extended periods.
• Ability to work with physical records or operate a computer or other office equipment.
• In some locations, ability to travel throughout the hospital system.
• In some locations ability to move up to 25 lbs.

Personal Protective Equipment

• Follows Standard Precautions using personal protective equipment as required for procedures.