Contract Manager V - Sr. Contract Manager
Job Description
In addition to the responsibilities listed below, this position is also responsible for drafting and/or consulting with the legal team on complex contract templates and language; responding to inquiries about complex contract templates and language; researching, comparing, and advising on contract rates and services; developing rate methodology and strategies; collaborating with various services lines to implement rate/contract strategies to improve access and availability and service delivery expansion; interpreting and translating contract terms for senior stakeholders; acting as a role model for the negotiation and completion of companion agreements, letters of intent, and/or memoranda of understanding; and monitoring provider programs in Pay for Performance Agreements, Pay for Quality Agreements, Value Based Purchasing Contracts, and Total Cost of Care.
Essential Responsibilities:
- Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
- Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
- Supports continuous improvement efforts by: leveraging innovative and data-driven approaches to identify and/or consult on continuous improvement opportunities across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); driving the implementation of process improvement initiatives to aid providers and business goals; collaborating with internal and external partners to develop network strategies and implement improved access to care; and may also include conducting and/or collaborating in complex modeling and analyses of provider and market data to develop recommendations, solutions, and action plans for improvement initiatives.
- Ensures contract commitments are met by: validating, maintaining, and/or conducting statistical analyses on provider and contract data of the day-to-day operation and management of services to identify trends and consult on provider compliance; documenting and reporting provider activities and/or coordinating with alternate stakeholders to ensure compliance with contract terms and conditions; promoting the use of guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures; and consulting with Provider Systems Administration (PSA) or its equivalent as needed to ensure proper contract interpretation and operational readiness and guiding corrective actions as identified through contract performance.
- Supports contract strategy development by: developing, proposing, and implementing short-term strategies that improve access to patient care while managing outside service costs; providing in-depth and advanced consultation on local service delivery planning and delivery system leadership to aid in the achievement of provider priorities and strategies; may include leading collaborative cross-functional workgroups to ensure provider strategies meet the unique needs of diverse stakeholders; and may also include developing materials and/or conducting peer training for new hires and contingent workers (e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines).
- Grows the Provider Network by: reviewing or identifying recommended/potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings using advanced knowledge of current service gaps; developing, maintaining, and managing trusted partnerships with providers to understand their unique service request needs and challenges; serving as a liaison between providers and KP by coordinating communication efforts (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by aiding in developing itineraries and agendas, gathering credentialing materials, and/or initiating this process.
- Contributes to provider satisfaction by: leveraging specialized knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, directories, other operational issues, and/or directories; leveraging innovative solutions to ensure requests for information, questions, and problems are efficiently identified, documented, and addressed; and in some instances, collaborating on and acting as a role model in the creation and delivery of complex training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
Minimum Qualifications:
- Minimum three (3) years of experience in a leadership role with or without direct reports.
- Bachelors degree from an accredited college or university AND minimum seven (7) years of experience in health care delivery or operations in a managed care environment, customer relationship management, or a directly related field OR Minimum ten (10) years of experience in health care delivery or operations in a managed care environment, customer relationship management, or a directly related field.
Additional Requirements:
- Knowledge, Skills, and Abilities (KSAs): Contract Management; Contract Law; Business Acumen; Business Process Improvement; Written Communication; Compliance Management; Applied Data Analysis; Trend Analysis; Knowledge Management; Business Relationship Management; Consulting; Interpersonal Skills; Key Performance Indicators; Project Management; Time Management; Quality Assurance Process; Computer Literacy; Presentation Skills; Health Care Reimbursement; Training; Business Planning
- Four (4) years of experience with health care regulatory compliance and filing, contract writing, health care operations, legal research, or insurance/health plan governance experience.
- Project Management Professional (PMP) or equivalent project/program management certification.
In addition to the responsibilities listed below, this position is also responsible for drafting and/or consulting with the legal team on complex contract templates and language; responding to inquiries about complex contract templates and language; researching, comparing, and advising on contract rates and services; developing rate methodology and strategies; collaborating with various services lines to implement rate/contract strategies to improve access and availability and service delivery expansion; interpreting and translating contract terms for senior stakeholders; acting as a role model for the negotiation and completion of companion agreements, letters of intent, and/or memoranda of understanding; and monitoring provider programs in Pay for Performance Agreements, Pay for Quality Agreements, Value Based Purchasing Contracts, and Total Cost of Care.
Essential Responsibilities:
- Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
- Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
- Supports continuous improvement efforts by: leveraging innovative and data-driven approaches to identify and/or consult on continuous improvement opportunities across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); driving the implementation of process improvement initiatives to aid providers and business goals; collaborating with internal and external partners to develop network strategies and implement improved access to care; and may also include conducting and/or collaborating in complex modeling and analyses of provider and market data to develop recommendations, solutions, and action plans for improvement initiatives.
- Ensures contract commitments are met by: validating, maintaining, and/or conducting statistical analyses on provider and contract data of the day-to-day operation and management of services to identify trends and consult on provider compliance; documenting and reporting provider activities and/or coordinating with alternate stakeholders to ensure compliance with contract terms and conditions; promoting the use of guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures; and consulting with Provider Systems Administration (PSA) or its equivalent as needed to ensure proper contract interpretation and operational readiness and guiding corrective actions as identified through contract performance.
- Supports contract strategy development by: developing, proposing, and implementing short-term strategies that improve access to patient care while managing outside service costs; providing in-depth and advanced consultation on local service delivery planning and delivery system leadership to aid in the achievement of provider priorities and strategies; may include leading collaborative cross-functional workgroups to ensure provider strategies meet the unique needs of diverse stakeholders; and may also include developing materials and/or conducting peer training for new hires and contingent workers (e.g., establishing contract language, determining payment rate parameters, defining workflow and business processes, and ensuring cross-training across all service lines).
- Grows the Provider Network by: reviewing or identifying recommended/potential partners/alliances for assigned service area to fill service gaps or decrease costs in current service offerings using advanced knowledge of current service gaps; developing, maintaining, and managing trusted partnerships with providers to understand their unique service request needs and challenges; serving as a liaison between providers and KP by coordinating communication efforts (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and ad hoc meetings by aiding in developing itineraries and agendas, gathering credentialing materials, and/or initiating this process.
- Contributes to provider satisfaction by: leveraging specialized knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or related to claims/disputes, billing, payment, reimbursement, directories, other operational issues, and/or directories; leveraging innovative solutions to ensure requests for information, questions, and problems are efficiently identified, documented, and addressed; and in some instances, collaborating on and acting as a role model in the creation and delivery of complex training materials to aid provider education and orientation on health plan systems, processes, and/or credentialing.
Minimum Qualifications:
- Minimum three (3) years of experience in a leadership role with or without direct reports.
- Bachelors degree from an accredited college or university AND minimum seven (7) years of experience in health care delivery or operations in a managed care environment, customer relationship management, or a directly related field OR Minimum ten (10) years of experience in health care delivery or operations in a managed care environment, customer relationship management, or a directly related field.
Additional Requirements:
- Knowledge, Skills, and Abilities (KSAs): Contract Management; Contract Law; Business Acumen; Business Process Improvement; Written Communication; Compliance Management; Applied Data Analysis; Trend Analysis; Knowledge Management; Business Relationship Management; Consulting; Interpersonal Skills; Key Performance Indicators; Project Management; Time Management; Quality Assurance Process; Computer Literacy; Presentation Skills; Health Care Reimbursement; Training; Business Planning
- Four (4) years of experience with health care regulatory compliance and filing, contract writing, health care operations, legal research, or insurance/health plan governance experience.
- Project Management Professional (PMP) or equivalent project/program management certification.
About Kaiser Permanente
At Kaiser Permanente, we’re all focused on helping people and providing high-quality, affordable health care services and to improve the health of our members and the communities we serve. Across our organization, we’re fiercely committed to our members, our mission, our communities, and each other. We know that each part of the Kaiser Permanente team is essential to our success. Together, we are more than 235,000 dedicated professionals working to advance Kaiser Permanente’s commitment to delivering a healthier tomorrow.
Driven by our collective passion at Kaiser Permanente, we strive to make health care more innovative and compassionate. With the wellness of our patients and our communities at heart, we work to revolutionize health and care from more than 650 locations in 8 states and D.C.
Related Jobs
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42929 A Day In The Life:This position will be responsible for assisting the Director, Corporate Operation...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42930 A Day In The Life:The Financial Reporting Systems Manager acts as a global subject matter/technical...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42927 A Day In The Life:The Accounts Payable Manager, North America, is a key leadership role within the...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42929 A Day In The Life:This position will be responsible for assisting the Director, Corporate Operation...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42930 A Day In The Life:The Financial Reporting Systems Manager acts as a global subject matter/technical...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42927 A Day In The Life:The Accounts Payable Manager, North America, is a key leadership role within the...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42929 A Day In The Life:This position will be responsible for assisting the Director, Corporate Operation...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42930 A Day In The Life:The Financial Reporting Systems Manager acts as a global subject matter/technical...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42927 A Day In The Life:The Accounts Payable Manager, North America, is a key leadership role within the...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42929 A Day In The Life:This position will be responsible for assisting the Director, Corporate Operation...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42930 A Day In The Life:The Financial Reporting Systems Manager acts as a global subject matter/technical...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42927 A Day In The Life:The Accounts Payable Manager, North America, is a key leadership role within the...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42929 A Day In The Life:This position will be responsible for assisting the Director, Corporate Operation...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42930 A Day In The Life:The Financial Reporting Systems Manager acts as a global subject matter/technical...
City : Chesterfield State : Missouri (US-MO) Country : United States (US) Requisition Number : 42927 A Day In The Life:The Accounts Payable Manager, North America, is a key leadership role within the...
Kaiser Permanente would like you to finish the application on their website.
