Sr. Contracts Administrator, Managed Care-Payor Contracting Details

Sr. Contracts Administrator, Managed Care-Payor Contracting

Kinetix - Houston, TX

Employment Type : Full-Time

We are searching for a Senior Contracts Administrator – someone who works well in a fast-paced hospital setting. In this position, you’ll be responsible for analysis, negotiation, and implementation of hospital and physician group contracts, letters of agreement (LOA), and single case agreements with commercial and Texas managed Medicaid health plans. In doing so, this position is responsible for developing and maintaining positive relationships with individuals at all levels of authority within each health plan, and the IDS, including CEOs, CFOs, and Vice Presidents. This position may interact with attorneys, directors, managers, and peers on a daily basis. This position is responsible for managing and completing major departmental projects including recommending project plans and recommending resource allocations.

Think you’ve got what it takes?

Job Duties & Responsibilities

• 
  Negotiates high volume, hospital and physician group contracts
• Prepares and analyzes financial reports in support of hospital and physician group contracting initiatives
• Develops and maintains strategic relationships with IDS personnel and health plans at all levels of authority
• Assures compliance with regulatory requirements and product requirements related to provider contracting functions
• Assists in the development of contracting strategy for hospital and physician group initiatives
• Implements new health plan contracts
• Supports management through communication, ad hoc reporting and quality improvement initiatives

Skills & Requirements

• 
  Bachelor’s degree
• A minimum of seven (7) years of applicable hospital managed-care experience, in a facility contracting, provider relations, or hospital business office role
• In lieu of a Bachelor’s degree, an additional four (4) years of related work experience is required
• Knowledge of industry regulations related to contracting and negotiation techniques, including knowledge of TDI and HHSC rules and regulations as they apply to the STAR & CHIP programs
• Knowledge of claims processes, medical management processes, medical terminology, and CPT coding
• Knowledge of CMS Medicare rules as may be appropriate
• Ability to review and negotiate provider contracts
• Ability to communicate effectively with internal staff and providers, and in regard to managed-care issues
• Proficiency in word processing, spreadsheet, and database software
• Strong organizational and follow-up skills