Job Summary:
We are seeking a highly motivated and detail-oriented Contract Manager – Payer Contracts to join our team at [BCHC]. This position is responsible for the development, negotiation, and maintenance of all payer contracts. The ideal candidate will actively contribute to the Health Center’s growth by establishing new payer relationships and expanding services with existing payers. The role encompasses managing the entire contract process, from pre-contract discussions to post-signature implementation, and working closely with the CEO, CFO, and internal departments to ensure that staff are kept informed of contract changes, updates to medical and billing policies, and the evolving payer landscape.
Key Responsibilities:
- Contract Development & Negotiation: Lead the negotiation, drafting, and execution of contracts with payers, ensuring that terms align with the Health Center’s goals and strategic objectives.
- Payer Relations: Build and maintain strong, productive relationships with payers to support the expansion of services and optimize contract terms.
- Collaboration & Communication: Work closely with the CEO, CFO, and other internal teams to keep stakeholders informed of new contracts, contract modifications, and policy updates.
- Contract Administration: Oversee the administrative aspects of contracts throughout their lifecycle, from initial discussions to post-signature management, ensuring timely implementation and compliance with terms.
- Policy & Billing Updates: Ensure that changes in payer policies and billing procedures are communicated effectively to internal staff, and collaborate with relevant departments to implement updates as needed.
- Compliance: Stay up to date with regulatory changes and ensure that contracts comply with applicable laws, rules, and regulations governing healthcare agreements.
Qualifications:
- Education: Bachelor’s degree or equivalent experience.
- Experience Preferred:
- At least 3 years of relevant experience in healthcare contracting, ideally with a focus on critical access hospitals, rural health clinics, physician practices, primary care, and/or health system contracting.
- Strong understanding of payer operations and healthcare reimbursement processes.
- Skills & Knowledge:
- In-depth knowledge of healthcare industry regulations, legal requirements, and payer contracting processes.
- Excellent negotiation, communication, and interpersonal skills.
- Strong attention to detail with the ability to manage multiple contracts and priorities simultaneously.
- Mindset & Approach:
- Ability to work hands-on and independently, with a proactive approach to identifying and solving problems.
- Collaborative team player who can work effectively with leadership and internal departments.
- Willingness to engage in all aspects of the contract administration process, from negotiation through implementation.
Physical Requirements:
- Ability to work at a desk for extended periods of time and use office equipment (computer, phone, etc.).