Health Plan Contract Manager

Job Summary

The Health Plan Contract Manager is a key contributor whose primary responsibility is contracting healthcare services provided by Community Bridges, Inc. (CBI) with Medicaid, Medicare and Commercial payers, and government entities (e.g. counties, cities, other municipalities). The manager serves as the point of contact for internal inquiries regarding health plan contract needs, implements contracting strategies identified by the Executive Leadership Team (ELT) and works collaboratively with all internal departments to ensure there is awareness and knowledge of contracts and contract requirements. The manager also participates in payer Joint Operations Committee (JOC) meetings and is position is also involved in contracts with Accountable Care Organizations. The administrator works closely with the VP Payer Relations to provide status updates on contracting opportunities, existing contracts that require amendments, and ensure legal review is completed prior to recommending signature. This position is also responsible for establishing the necessary structures for tracking and monitoring contracts through the lifespan to ensure contracts are current.

Qualifications & Requirements

• Bachelor's Degree in Business Administration or Healthcare Management, or a related field required; Master's in Business Administration or Public Administration preferred
• Two (2) or more years of leadership experience required
• Five (5) or more years of experience in contract management/negotiation of healthcare contracts (Behavioral Health, Addiction, Integrated Care) in multiple settings (e.g. outpatient, facility, physician/provider, etc.) required
• Experience with rate setting and analysis required; three (3) or more years preferred
• Working knowledge in key healthcare operations (e.g., claims/billing, coding, credentialing) required
• AHCCCS Health plan contracting experience strongly preferred
• Knowledge of healthcare industry – statutes and regulations in Medicaid, Medicare, and Commercial systems; knowledge of behavioral health, addiction and physical health services strongly preferred
• Knowledge of multiple reimbursement strategies: FFS, Pay for Performance, Full Risk strongly preferred
• Knowledge of ACOs and contracting with ACOs strongly preferred
• Commercial Health Plan Contracting Experience and building relationships preferred
• Accountable Care Organization experience preferred
• Multi-state healthcare payer strategy or contracting experience preferred

Benefits

• Generous PTO accrual (5 weeks!)
• Medical, Dental, Vision, Disability, Life, Supplemental plans
• Hospital indemnity / Critical Illness
• Pet Insurance
• Dependent Care Savings, Health Care Savings
• 401K with employer match – 100% vested upon enrollment
• Wellness programs
• Tuition Reimbursement and Scholarship Programs
• Incentives and more!