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Senior Contracts Manager in Los Angeles, California, US at TeamHealth

Date Posted: 9/16/2020

Job Snapshot

Job Description

JOB DESCRIPTION OVERVIEW:

The Senior Contract Manager has the overall responsibility to conduct negotiation and re-negotiation of Managed Care Plans on behalf of physicians practicing in the specialties of primary care, emergency medicine, and in-patient services for large volume state and regional/ national contracts.  The Senior Contract Manager will provide staff support in the coordination and management of Team Health’s internal review process for negotiating Managed Care Plans.  This includes analysis of proposed contracts, coordinating financial impact studies, and proposing negotiating tactics for the Managed Care Department.  The Senior Contract Manager is also responsible for the supervision of the Managed Care Specialist and Contract Managers in his/ her region.  The Senior Contract Manager is responsible for training of new managers and specialist staff in his/ her region.  The Senior Contract Manager’s responsible tasks, at any current time, (including new contracts, re-negotiations, amendments, projects) is 1.5 to 2 times the workload of the contract managers.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • The Senior Contract Manager shall conduct negotiation and re-negotiation of Managed Care Contracts to include contract language and proposed reimbursements such as percentage of charges, case rate, capitation, and other variations for high volume state and regional contracts.  The Contract Manager will review in detail each proposed Managed Care Agreement and make recommendations for changes and modifications to conform to Team Health contracting guidelines.  Contract terms must fall within the NCQA credentialing guidelines.
  • The Senior Contract Manager shall maintain liaison with Medical Directors, affiliate CFOs, Contract Management and/or individual group physicians on the current status of all Managed Care Plans actively under negotiation.
  • The Senior Contract Manager is responsible to be a resource person to other department personnel for any/all Managed Care Plan’s currently in negotiation or in effect.  This includes, but is not limited to, problem solving technique’s as required.
  • The Senior Contract Manager is responsible to communicate the progress of negotiations, discuss strategies, and recommended postures with the Director, Managed Care and other involved members of the Affiliate and Billing Service for client contracts.
  • The Senior Contract Manager is responsible to coordinate financial feasibility analysis and impact studies regarding the proposed contract rate and its impact on the Accounts Receivable and collections for the affiliate. 
  • The Senior Contract Manager is responsible for the supervision of the Managed Care Specialist and Contract Managers, to assure the timely execution of contracts, to coordinate maintenance of spread sheets, and to distribute information to contract management.
  • The Senior Contract Manager is accountable and must work with contract management department to manage the contract file for all Managed Care Plan’s including updates on pending expirations and proposed amendments and file maintenance.  Coordinate all aspects of the negotiation of Managed Care Plans.
  • Organize/implement a system to monitor contract review dates with Contract Management department.
  • Always refers unsolved problems to Director, Managed Care, and consults when necessary.
  • Prepares reports as assigned by the Director completely, accurately, and within assigned time frames.
  • The Senior Contract Manager may participate in interpretation of contracts to assist Contract Management Department in the resolution of claim filing issues to assist in obtaining payments.
  • Other duties as assigned.

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • Ability to work independently and exercise judgement in negotiating contracts or representing Team Health to clients.      
  • Very well organized, ability to handle multiple practices.
  • Ability to effectively carry out position responsibilities.
  • Ability to prioritize and assign work to the Managed Care Specialist as Necessary.
  • Excellent written and verbal communication skills. 
  • Comprehension of legal contracts and contract language for specialties to include primary care, emergency medicine, and in-patient services.
  • Understanding and ability to practice negotiation techniques.
  • Ability to supervise others.
  • Bachelors degree in Business with Masters preferred or equivalent experience. 
  • 7 to 10+ yrs experience in physician medical billing, with 4+ years specific experience in Managed Care Contracting required, preferably carrier and provider background.
  • Experience working in a computerized environment.
  • Experience with Managed Care Programs, the Managed Care market, and all reimbursement schemes that exist in the Managed Care industry.

SUPERVISORY RESPONSIBILITIES:

  • Manages Managed Care Specialist and Contract Managers

PHYSICAL / ENVIRONMENTAL DEMANDS:

The functions of the position include interrelating with the following elements of the organization:

  • Medical Director’s/Physician’s
  • The Healthcare Financial Services management staff.
  • TeamHealth Employees
  • Hospital Staff
  • Data Processing
  • Billing Center Employees
  • Contract Management Staff

The position entails the ability to work in a high stress office environment.  There are schedules and deadlines and frequent changes of work assignment. 

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.

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