Department/Unit:
Integrated Delivery Systems
Work Shift:
Day (United States of America)
Salary Range:
$77,075.00 - $119,466.00Contract Administrator
Albany Med Health System Payer Contracting
Albany, NY
The Contract Administrator - System Payer Contracting makes data-supported recommendations, supports the development of AMHS contracting strategies, and, as assigned, negotiates with established and new payers, both commercial and governmental. The Contract Administrator prepares contract proposals for internal review and consideration, prepares for and conducts meetings/negotiations, presentations, and other organizational functions as assigned.
This office is located at 1275 Broadway, Albany NY. However, this position will be required to travel to our affiliate locations for scheduled meetings which include: The Saratoga Hospital, Glens Falls Hospital, Columbia Memorial Hospital.
Essential Duties and Responsibilities include:- The Contract Administrator, System Payer Contracting meets with representatives of payers
- managed care organizations and other agencies to assist in the evaluation of current contracts or development of new contracting opportunities to include those under Federal and NYS reform for AMHS.
- Reviews proposals and makes data informed recommendations for internal consideration in preparation for negotiations.
- In conjunction with the Director or at the direction of VP for Payer Contracting negotiates contract parameters and methodologies and prepares/presents proposals representing AMHS's position.
- Works cross functionally across AMHS to evaluate and develop such proposals identifying opportunities and risks.
- Collaborates with the Legal and Compliance Department and other departments across AMHS to ensure compliance and implementation capabilities.
- Works cross functionally across AMHS to review terms and performance of each established contract portfolio
- Mediates contract disputes to resolution and ensures compliance (both internally and externally) with contract provisions.
- Monitors contract renewal dates to ensure appropriate review is conducted. Coordinates with Finance and others to ensure timely/applicable contract analyses.
- Reviews for risks and works collaboratively with Financial Reporting to ensure appropriate modeling. Understands all modeling parameters and reports on such.
- Monitors contract performance by independently collecting data, analyzing and completing spreadsheets to include comparative and economic assessments and reports.
- Maintains broad knowledge of payers in the AMHS market and beyond, whether contracted or not. Assists with gathering of current data on all major managed care organizations, including information regarding: financials, current membership, physician networks and current/future marketing plans. Assists with the development of and prepares/presents reporting instruments for the AMHS.
- Maintains the absolute confidentiality of patients and AMHS contracts,
- Performs special projects and assignments as requested by the Director or VP for Payer Contracting. Assists with IDS Affiliate contracting processes related to payer contracting.
- Knowledge base must remain current in changes regarding Federal and New York State regulations of provision/reimbursement of medical services including but not limited to federal and NYS VBP Roadmaps.
Qualifications: - Bachelor's Degree in Business and/or Health Care Administration is required
- Minimum of 4 years in managed care negotiations and managed care network operations required
- Minimum of 1 year of experience in leading complex payer negotiations and mediation is required
- Equivalent combination of relevant education and experience may be substituted as appropriate
