Contracts manager Jobs in Huntington beach ca
Last updated: 1 day ago
Contracts Manager
The Midtown GroupOrange,, California- Promoted
CONTRACTS MANAGER - HEALTH CARE PROVIDER
Sunshine Enterprise ConsultingCA, United States- Promoted
Contracts Manager / Contracts Counsel
Larson MaddoxCA, United States- Promoted
- Promoted
Senior Contracts Manager
Highbury Defense Group, an Accelint companyCA, United States- Promoted
Contracts Analyst
Los Angeles Capital Management LLCCA, United States- Promoted
Contracts Lead Admin
DeloitteCosta Mesa, CA- Promoted
Contracts Manager
VirtualVocationsSanta Ana, California, United StatesContracts Manager - Onsite
US Tech Solutions, Inc.Orange, CASection Manager III - Procurement & Contracts
Orange County Transportation AuthorityOrange, CaliforniaContracts Management Sr. Manager - Level 6
Lockheed MartinCalifornia- Promoted
Contracts Manager (Health Insurance) on-site Orange CA
INSPYR SolutionsOrange, CA, US- Promoted
Real Estate / Data Center Contracts Attorney
Lawyers On DemandCA, United StatesManager, Provider Contracts
Molina HealthcareCaliforniaContracts Analyst
Center for Autism and Related DisordersCalifornia Remote, USContracts Specialist
Nth GenerationCA, CA, USAContracts Manager
Impresiv HealthOrange, CA- Promoted
Sr. Contracts Paralegal
Ultimate StaffingCA, United StatesContracts Manager
The Midtown GroupOrange,, California8 days ago
Salary
$43.66–$69.86 hourly
Job description80% - Contracting Functions Negotiates, implements and manages provider network contracts, health networks, professional, ancillary and facility providers, as assigned. Negotiates LOA for members being directed to out of network providers for covered services, reviews requests for accuracy and appropriateness and attempts to identify opportunities to redirect member(s) to in-network providers, as needed. Maintains and reports the status of LOA dispositions, develops action plans to transition non-contracted providers to full contracts when possible and collaborates with other staff to monitor and expedite the credentialing / contracting process. Optimizes and maintains accuracy and integrity of new and existing provider contracts to ensure compliance with Department of Health Care Services (DHCS) and Centers for Medicare & Medicaid Services (CMS) mandates. Manages project plans when implementing network-wide contract initiatives. Coordinates with legal, Medical Management, Provider Relations, Finance and OneCare Sales and Marketing to implement new and renewing provider contracts. Monitors performance and utilization trends of assigned networks to assess new opportunities for cost savings, alternate delivery models and financial risk sharing through contractual arrangements. Works with leadership to identify and problem-solve provider contracting issues. Negotiates, implements and manages provider network contracts, health networks, professional, ancillary and facility providers, as assigned. Negotiates LOA for members being directed to out of network providers for covered services, reviews requests for accuracy and appropriateness and attempts to identify opportunities to redirect member(s) to in-network providers, as needed. Maintains and reports the status of LOA dispositions, develops action plans to transition non-contracted providers to full contracts when possible and collaborates with other staff to monitor and expedite the credentialing / contracting process. Optimizes and maintains accuracy and integrity of new and existing provider contracts to ensure compliance with Department of Health Care Services (DHCS) and Centers for Medicare & Medicaid Services (CMS) mandates. Manages project plans when implementing network-wide contract initiatives. Coordinates with legal, Medical Management, Provider Relations, Finance and OneCare Sales and Marketing to implement new and renewing provider contracts. Monitors performance and utilization trends of assigned networks to assess new opportunities for cost savings, alternate delivery models and financial risk sharing through contractual arrangements. Works with leadership to identify and problem-solve provider contracting issues. 15% - Administrative Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the teams in carrying out department responsibilities and collaborates with others to support short- and long-term goals / priorities for the department. Develops desktop procedures, network overviews and identifies network nuances that improve processes and workflows. Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the teams in carrying out department responsibilities and collaborates with others to support short- and long-term goals / priorities for the department. Develops desktop procedures, network overviews and identifies network nuances that improve processes and workflows. 5% - Completes other projects and duties as assigned. Bachelor's degree PLUS 4 years of experience with provider contracting, negotiation, hospital and delegated health network / medical group provider agreements or other complex provider contracts required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. Experience with Medi-Cal and Medicare lines of business within a health plan or large health care delivery system required. Experience with Medi-Cal, Medicare fee-for-service reimbursement rates, and capitation methodologies required. 4 years of contracting and network management experience in California with a health plan or large provider delivery system. N / A Develop rapport and establish and maintain effective working relationships with leadership and staff and external contacts at all levels and with diverse backgrounds. Work independently and exercise sound judgment. Communicate clearly and concisely, both orally and in writing. Work a flexible schedule; available to participate in evening and weekend events. Organize, be analytical, problem-solve and possess project management skills. Work in a fast-paced environment and in an efficient manner. Manage multiple projects and identify opportunities for internal and external collaboration. Motivate and lead multi-program teams and external committees / coalitions. Utilize computer and appropriate software (e.g., Microsoft Office : Word, Outlook, Excel, PowerPoint) and job specific applications / systems to produce correspondence, charts, spreadsheets, and / or other information applicable to the position assignment. Ability to visually read information from computer screens, forms and other printed materials and information. Ability to speak (enunciate) clearly in conversation and general communication. Hearing ability for verbal communication / conversation / responses via telephone, telephone systems, and face-to-face interactions. Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting. Lifting and moving objects, patients and / or equipment 10 to 25 pounds Work is typically indoors and sedentary and is subject to schedule changes and / or variable work hours, with travel as needed. There are no harmful environmental conditions present for this job. The noise level in this work environment is usually moderate. Work is typically indoors in a clinical setting serving the frail and elderly. There may be harmful or hazardous environmental conditions present for this job. The noise level in this work environment is usually moderate to loud. Work is typically indoors and sedentary and is subject to schedule changes and / or variable work hours, with travel as needed. Employee will occasionally work outdoors in varied temperatures. There may be harmful or hazardous environmental conditions present for this job. The noise level in this work environment is usually moderate to loud.
Hourly Rate : $43.66 - $69.86 / hr
Offer will be made by the client based on experience and based on their internal scale!
Monday to Friday, Fully In-Office (8am to 5pm)
Job Summary
One of our most prestigous healthcare clients is seeking a highly motivated an experienced Contracts Manager to join our team. The Contracts Manager will be responsible for developing, maintaining and negotiating contracts with health networks, professional, ancillary, facility providers, including processing Letters of Agreement (LOA). The incumbent will participate in network development, physician recruitment, rate proposal analyses, negotiations and coordination to ensure appropriate and timely implementation of provider contracts and provider networks, as assigned. The incumbent will support contracts approved by the Board of Directors and Provider Network Operation’s leadership.
Position Information :
- Department : Contracting
- Salary Grade : 313 - $43.66 - $69.86 / hr
- Work Arrangement : Full Office
Duties & Responsibilities :
Minimum Qualifications :
Preferred Qualifications :
Required Licensure / Certifications :
Knowledge & Abilities :
Physical Requirements (With or Without Accommodations) :
Work Environment :
If located at the 500, 505 Building or a remote work location :
If located at PACE :
If located in the Community :
The Midtown Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.