Contract Manager

Contract Manager – Tempe, AZ

This position develops and negotiates preferred and exclusive contracts with healthcare providers for durable medical
services. This includes facilitating and performing effective and comprehensive reviews of network provider contracts to ensure legal terms and conditions, financial, product and pricing terms are aligned with organizational objectives.

Responsibilities include the following:

  • With a focus on pricing and service level agreements (SLA), participates in the approval process for all durable
    medical equipment (DME) contracts. This may include but is not limited to negotiating discounted fee schedules
    with health care providers as aligned with corporate goals and requirements.
  • Compares and contrasts service providers’ and program managers’ performance to one another in the area of cost
    per ACD and cost per patient in service.
  • Researches and analyses provider fees using system generated data as well as outside data to determine discounted
    fee schedules within the organization’s mission and designated goals.
  • Analyzes, maintains and reports internal cost containment programs and results. This includes but is not limited
    to updating and distributing all materials relevant to cost containment programs on a regular basis. On an ongoing
    basis, develops and enhances documented processes relative to cost containment protocols and contracting
    procedures.
  • Coordinates and implements new provider contracts with each provider office and their staff. This includes but is
    not limited to providing written directions for billing, verification of eligibility, and other contractual requirements.
  • Coordinates the internal implementation of contracts working closely with each organizational function (customer
    service, claims, sales, etc.) to understand how operations, processes and procedures should be conducted. This may
    be accomplished via training or written communications.
  • Maintains necessary system generated fee schedules and other exhibits required as part of each agreement with the
    health care provider.
  • Maintains contract and provider data and provides status reports on a regular basis and as needed. This includes
    but is not limited to preferred provider listings, monthly management reports on participating and non-participating
    cost savings and performance, cost containment developments, provider contract statuses, etc.
  • Identifies DME vendors participates in the RFP process for DME providers. Monitors contract compliance of DME
    vendors as appropriate.

Knowledge, Skills and Abilities:


Education, Licensure or Certification:

  • A thorough knowledge and understanding of business, finance or accounting as normally obtained through the completion of a Bachelor’s Degree in Business, Finance or Accounting

Work Experience or Related Experience:

  • The ability to effectively coordinate and negotiate favorable contracts on the company’s behalf as normally obtained through five years progressively responsible experience with provider contracts to include contract components, fee schedule determinations, credentialing, claims processing and pricing
  • Experience in the healthcare or medical fields in which incumbents have gained an understanding of durable medical equipment is strongly preferred

Specialized Knowledge, Skills & Abilities:

  • A high level of professionalism, customer service and discretion is required to represent the organization and interact with other organizations as described
  • Must be proficient to report on key performance indicators (KPIs) for the DME program
  • Must be able to diplomatically address and resolve DME issues with vendors and internal customers. This requires
    good interpersonal skills in order to establish relationships and negotiate with DME vendors.
  • Exceptional in-depth understanding of healthcare insurance and insurance knowledge and related operations is
    required
  • Knowledge of provider fee schedule development in healthcare
  • Advanced software skills including word processing, spreadsheet analytics, presentations, etc. are required to
    perform the functions described
  • Detail orientation with strong analytical and mathematical skills are essential
  • Effective project management skills and the ability to remain focused and organized given multiple priorities is
    essential. This includes the ability to prioritize, multi-task, work under pressure and with tight deadlines, and work
    independently toward objectives
  • Strong communication, presentation and interpersonal skills are required

Equipment:

  • Working knowledge of a PC, business and communications software (MS Office) and web-based tools are required
  • Familiarity with Quick Book Enterprise software is strongly preferred

Physical Requirements and Demands:

  • This position entails a high level of work performed at a computer terminal throughout the day as well as moderate use of a telephone or headset equipment

NOTE: To apply for this position, please send your resume and/or relevant work experience to jtice@stateserv.com and reference job number 2109.