Log In
Sign Up
Growing organization with a focus on providing collaborative and creative solutions for our clients.
We are a full-service physician practice and revenue cycle management company and we are looking for a dynamic and driven Contracts Manager to join our team.
Primary Requirements of this position:
Thorough understanding of payer contracting strategies, contract language, payment structures and critical components of contracts to ensure appropriate recommendation to the Client. ·
Understanding of payor structures in Managed Care environments, including Capitation, FFS, Value Based payments, Delegated Risk Models, Carve-Outs, etc. ·
Oversee client contracting activities to ensure efficiency and maintain compliance with Company policies and standards, government laws and regulations. ·
Negotiate contracts and administer agreements with payers including health plans, IPAs, and other third-party payers. ·
Perform reimbursement analysis to identify rate improvement opportunities, categorize additional revenue initiatives, develop strategies to help clients reach financial goals, and execute contracting strategies to meet goals and objectives for our Clients. ·
Prepare and coordinate financial and utilization analyses to develop recommendations for compensation methodologies. ·
Routine and consistent use of software tracking tools to manage status of contract activities, contacts, effective dates, termination provisions, etc. ·
Work collaboratively with cross-functional teams involving internal and external client representatives. ·
Timely sharing of contract updates with RCM to ensure system set up for provider profiles, contract fee schedules, etc. ·
Participate actively in strategic meetings as required to improve the company’s operational efficiencies. ·
Participate in other projects affecting contracting and credentialing, and other special projects as needed. ·
Provide an exceptionally high level of customer service and responsiveness in all communications with providers and other internal and external stakeholders.
Must have a minumum of three (3) years of experience in a Managed Care contracting environment.
