Contract Manager, Managed Care Contracting

Exemption Status: Exempt Hiring Range: $83,116.80 – $149,593.60 (final offer may vary based on experience, skills, qualifications, and internal equity considerations). Schedule: Monday through Friday, 8:00‑5:00, Day Shift, 40 hours. Position Overview Responsible for the implementation and renewal of managed care contracts for the medical center and physicians, and for ancillary service and member hospital managed care contracts. Major Responsibilities Respond to all inquiries relating to managed care contracts from medical center personnel, physicians, and/or physician office staff; interpret contract language and ensure accurate communication and implementation. Coordinate with Managed Care Provider Relations staff to communicate contractual requirements, updates on policy and operational changes, and other contract‑related information to various departments. Coordinate site visits required for credentialing for new and existing programs. Act as primary liaison with managed care plans to address operational issues; meet regularly with plan representatives to ensure contractual obligations are met and resolve issues raised by UMass Memorial Medical Center and UMass Memorial Medical Group personnel. Manage contracts to ensure compliance; with input from Director, Legal, Finance, and other departments, be responsible for renewing and renegotiating contract terms; assist with financial analysis and negotiation of risk contracts; assist in contracting for ancillary services, including home health & hospice and MRI services, and affiliate hospital risk contracts. Help resolve technical and operational problems; evaluate the impact of solutions to ensure goals are achieved. Position Qualifications License/Certification/Education: BS degree or equivalent in Business, Health Care Administration, or Managed Care Administration. Experience: Five years in a hospital, physician office, clinical, or managed care setting with a thorough understanding of clinical operations, health care terminology, and current market conditions. Three years of direct managed care contracting experience, emphasizing analysis and negotiation of risk contracts and understanding of managed care financial arrangements and boilerplate negotiations. Experience with risk contracting preferred. Good knowledge of commercial Medicare Advantage and Managed Medicaid markets preferred. Excellent verbal and written communication skills. Proficiency with Microsoft Office applications. If certification, licensure, or registration is not required, an equivalent combination of education and experience may substitute for the above requirements. Equal Opportunity Statement All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity and expression, protected veteran status, or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at View email address on click.appcast.io. We will make every effort to respond to your request for disability assistance as soon as possible. #J-18808-Ljbffr C999 UMass Memorial Health Care, Inc.