Manager of Contracts

Duties and Responsibilities

• Leads complex contracting and reimbursement negotiations, including outreach and contract negotiations with provider network and vendors.
• Oversee the contract lifecycle including loading, submissions, and coordination with matrix partners for network implementation and maintenance.
• Ensure that contracts comply with DHS and CMS regulations.
• Ensures departmental compliance with provider roster and credentialing requirements.
• Monitor contracts, enforce contract terms, and ensure renewals and amendments are completed in a timely manner.
• Manage network adequacy in alignment with business needs and regulatory guidelines.
• Lead contract onboarding and education on CEI/PACE requirements.
• Maintain contract performance and support timely issue resolution.
• Oversee the finalization of Letters of Agreement and Memoranda of Understanding.
• Prepare, analyze, review, and project the fiscal impact of complex contracts, including value-based care and alternative payment arrangements.
• Update the Provider Manual annually.
• Oversee the accuracy of contracting and purchasing software systems.
• Develop and implement departmental policies and procedures.
• Monitor and review departmental duties, compliance, and workflow to ensure policies are implemented with the highest level of efficiency and accuracy.
• Perform supervisory duties, including interviewing, hiring, training employees, assigning work, and supporting staff development.
• Evaluate the performance of direct reports, recommend training, and maintain staff at the level of skill necessary to meet organizational objectives.
• Build relationships that support external and internal partnerships and identify broader business opportunities that advance the organization’s strategy.

Qualifications

• Requires a bachelor’s degree in health care administration, business administration, finance, public administration, or a related field.
• Requires five years of experience in contract negotiations, fiscal management, or a related field.
• Supervisory or leadership experience preferred.
• Experience in using contract management systems, provider databases, and reporting tools preferred.
• Requires knowledge of Medicare, Medicaid, and commercial reimbursement practices, as well as three years of experience in physician, health care, and vendor contract negotiation and administration.
• Familiarity with terms and conditions for services and in-depth knowledge of legal terminology.
• Knowledge of ICD-9, ICD-10, CPT, and HCPCS codes is preferred.
• Demonstrates an elevated level of diligence and attention to detail.
• Proficient in Microsoft Office, including Excel, Word, and PowerPoint; experience with contract management software is preferred.
• Demonstrates excellent written and verbal communication skills, with the ability to communicate clearly, concisely, and effectively at all levels of the organization.
• Demonstrates the ability to plan, organize, and meet deadlines while managing numerous and changing priorities.