Job Description:Role Summary:The Contract Manager will report to OneOncology's Sr.Manager, Contract Management. This role will be accountable for contract life cycle /performance of assigned physician practices, including negotiations and strategy development. The contract lifecycle will include negotiations and strategy development, maintenance, and contributing to value-based care development. This position does not typically have any direct or indirect employees to manage. This is a remote position that does require some travel and proximity to a major airport.
Responsibilities: - Assists in detailed analysis of performance, and provide evaluation, on existing payer contracts in assigned practices.
- Actively participates in developing payer strategies and business goals with the leadership team for assigned practices/markets.
- Assures contractual arrangements meet financial targets and legal/regulatory compliance requirements.
- Leads payer negotiations including managing template versions, review/approval process and multiple concurrent negotiations.
- Works with internal team members to coordinate analytic requirements and other projects impacted by contract negotiations/revenue.
- Accountable for all payer related issues and ensuring practices have timely support as needed.
- Responsible for the accuracy of supporting documentation for contracts and completing documents accurately
- Ensures contractual language is kept current; evaluate fee schedule on a yearly basis to identify opportunities for additional covered services, medical policy changes and reimbursement.
- Provide training and education to practice stakeholders as needed on any payer related subject.
- Ensures practices have access to and properly utilizes all payer tools.
- Creates and maintains productive and professional relationships between operations, partner practices and payers.
- Ability to work in a matrix environment where multiple and competing customer demands are likely.
- Focuses on client satisfaction through internal and external communication.
- Demonstrate proficiency with financial reports and modeling.
- Assist in the development of other team members through mentoring if necessary.
- Participate in the development and/or advancement of value-based care programs.
- Additional responsibilities as assigned to help drive our mission of improving the lives of everyone living with cancer.
Required or Preferred Qualifications: - Associate's or Bachelor's degree required in business, finance, healthcare administration or other relevant fields of study.
- Master's degree preferred but not required.
- Minimum 5 years relevant experience working with hospital, clinic, physician practice or healthcare system contracting.
- Demonstrated knowledge and understanding of the legal and regulatory requirements in the healthcare industry.
- Current industry experience negotiating physician contracts required.
- Current or previous payer contracting experience preferred but not required.
- Travel flexibility as needed.
Essential Competencies: - Excellent written and verbal communication skills.
- Strong negotiation skills.
- In depth knowledge of Medicare, Medicaid, and commercial insurance.
- Demonstrates proficiency with financial reports and modeling.
- Ability to utilize contract management software tools.
- Conflict resolution skills and strong relationship building skills.
- Strong attention to detail.
- Innovative problem solving and strong critical thinking skills.
- Ability to manage multiple complex projects at the same time.
- Participated in implementation of contract management software tools.
- Experience in value-based care program development.
- Attendance is an essential job function.
This job description does not contain a full listing of activities, duties or responsibilities required of this role. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.
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