Contracting Manager

Contracting Manager

 

PURPOSE OF THE POSITION:

Responsible for development and maintenance of a comprehensive provider network.

 

KEY RESPONSIBILITIES:

1. Assist in the planning and implementation of a provider network development strategy.
2. Direct responsibility for the negotiation, execution and implementation of hospital, IPA, major vendor and key medical group agreements. 
3. Ensure all agreements are in compliance with regulatory requirements.
4.  Develop and maintain provider contracting policies and procedures.
5. Identify medical cost improvement opportunities and develop and maintain key provider pricing strategies that conform to automated claim payment capabilities and contribute to the management of overall medical costs.
6. Develop and maintain a system to measure, monitor and minimize potential risk and monitor financial performance through the negotiation and implementation of key provider contracts.
7.  Develop and maintain provider contracting standards and an exception process to manage provider agreements that may deviate from the standards.
8. Work collaboratively with key stakeholders and partners at the corporate level and locally including Legal, Medical Management, Finance, Claim, Customer Services, Regulatory Affairs and Marketing.

 

KNOWLEDGE AND SKILLS REQUIRED:
1. Master's in business and/or health care administration or a related area of study with business experience.
2. Minimum of five years managed care experience including three years of successful negotiating and contracting with key provider types. 
3. Excellent oral and written communication skills including the ability to communicate both simple and complex terms at different organizational levels.
4. Strong knowledge and understanding of hospital and managed care financing.
5. Excellent organizational and analytical skills.
6. Extensive knowledge of claims payment methodologies and system requirements, procedures and controls.
7. Proficiency in computer applications including Microsoft Word and Excel and ability to utilize COGNOS. 

 

To Apply:
Please send cover letter with resume and salary required to: MetroPlus Health Plan, Human Resources Department, 160 Water Street, 3rd Floor, New York, New York 10038, Attn: Employment Manager; or fax to 212-908-8712; or e-mail to: mhpemplopps@nychhc.org

 

EOE - NYC Health & Hospitals Corporation - NYC Residency is required.