Wouldn't it be nice to work for a company where the mission makes sense, the salaries are competitive, the company listens to the needs of the employees and the office is professional yet the dress is casual?
Colorado Access is a nonprofit health plan serving the medical and behavioral needs of the medically underserved in Colorado. We offer an excellent benefit and compensation package, including medical, dental & vision, 401(k), tuition reimbursement, and competitive PTO.
We are currently looking for a Manager Provider Contracting responsible for managing the entire contracting process including negotiations, contract offers and contract implementation. The position is responsible for being proficient in current and proposed reimbursement methodologies, contract language and provisions. As needed, will manage, develop and provide training to network providers. Directly supervises staff in the department, including establishing goals and accountabilities for the staff.
Essential Functions Summary:
Negotiates contracts utilizing a variety of negotiation strategies and techniques.
Maintains knowledge in organization operations to assure contract offers can be implemented and effectively administered.
Responsible for ensuring the network adequacy and provider capacity targets are achieved across all lines of business within the service area.
Manages the entire contracting process including negotiations, contract offers and contract implementation.
Responsible for the development and revision of: contract templates in collaboration with the Legal department, contracting guidelines and capacity standards.
Works with contracted providers on contract interpretation issues.
Manages Departmental reporting requirements, and ensures all required regulatory and contractual reports are submitted accurately and timely.
Responsible for department staff, either directly or indirectly, to include recruiting, interviewing, hiring, coaching, counseling and completing performance evaluations.
Provides financial and operational performance analysis of existing and pending Provider contracts.
Provides guidance, support and direction to Provider Contract Managers and other department staff.
Requires a Bachelor's degree in health administration, business administration or related field with a Masters' degree preferred.
Basic knowledge of managed care contracting, provider reimbursement and claims payment, medical terminology, and health care delivery systems required. Knowledge of local health and community agencies and providers preferred.
Three to five years experience negotiating complex contracts with health care providers (e.g., hospitals, medical groups).
A working knowledge of the various medical reimbursement platforms including the Resource Based Relative Value System and Diagnostic Related Groups. Strategic planning. Development, revision and quality control of contract templates, contracting guidelines.
Requires a valid Colorado driver's license.
Please send, fax or e-mail your resume and cover letter with salary requirements to:
Attn: Human Resources
10065 E. Harvard Ave., Ste 600
Denver, CO 80231
Hiring decisions will be made without regard to race, creed, color, national origin, sex, marital status, religion, ancestry, mental or physical handicap, age or sexual orientation. EOE.
AllHealthCareJobs - 12 months ago
Colorado Access is a 501(c)4 corporation operating as a nonprofit health maintenance organization with an emphasis on primary care and quali...