Senior Contract Manager Job in Boston, Massachusetts US
Status:
Full Time, Employee
Relevant Work Experience:
5+ to 7 Years
Education Level:
Bachelor's Degree
Location:
Boston, Ma
Job Category:
Legal
Career Level:
Manager (Manager/Supervisor of Staff)
Job Description
Summary:
Neighborhood Health Plan (NHP), located in Boston, is currently seeking an experienced, highly skilled Senior Contract Manager . The Senior Contract Manager is responsible for the evaluation, negotiation, execution, implementation and on-going management of complex provider contracts, including risk based agreements and large IPA / PHO /MCA agreements. S/he will act as a resource for Contract Managers and Provider Relations staff, as well as for other Provider Network Management (PNM) staff and key PNM and NHP leadership.
Primary Responsibilities:
- Evaluate, negotiate and recommend necessary changes to existing contracts to ensure that targeted provider performance and financial goals are met.
- Identify medical cost improvement opportunities, the development of contracting action plans and facilitation of regular meetings with appropriate provider representatives to achieve results.
- Manage the delivery of financial settlements and the collection of receivables.
- Act as a liaison to partners and providers to ensure understanding of company policies, administrative procedures and practices.
- Act as a resource and provide training, as required, to ensure staff has the resources to meet performance goals and objectives, develop and implement feedback mechanisms to determine satisfaction levels relative to administrative support, service, communications and reimbursement.
- Work, in conjunction with Provider Relations, to ensure that the company addresses Provider's issues and concerns.
- Initiate changes and recommendations for solutions to improve ongoing compliance and ensure reimbursement strategies and other objectives are met in future contract periods.
Preferred Qualifications:
- Bachelor's degree in Business or Health Care Administration with a financial emphasis or equivalent work experience. MBA, MPH, MHSA, MHApreferred
- 5-7 years in managed care industry along with strong negotiation skills, well developed verbal and written communication skills and analytical skills.
- Healthcare background, negotiating experience. Knowledge of the managed care market and the regulatory environment.
- Strong ability to work with communications and analytical software and systems.
- Proven track record of superior financial, analytic, decision-making, consensus building and negotiating skills. Proven leadership skills.
- Proven achievement of medical cost management targets.
NHP offers competitive salaries and an excellent flexible benefits package that includes medical, dental and vision insurance, generous earned time, commuter benefit, and a 401(k) employer contributed retirement program.
NHP's mission targets a diverse population and our employees are just as diverse. As an equal opportunity employer, NHP recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds.
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