Contract Manager, Managed Care Job Listing at SutterHealth in Sacramento, CA

 The position is responsible for participating in the negotiations for Payer agreements as assigned for Sutter hospital, professional and ancillary providers. The primary focus of this position is to support the negotiations, implementation of the managed care agreements and contract compliance. Additionally, the Contract Manager coordinates closely with operational departments within Sutter to assure the success of contract performance and work through any contract disputes. The incumbent may assist the Directors or Vice President of Managed Care or others in special projects as assigned.

Education:

A bachelor’s degree in Healthcare Administration, Business Administration or other related healthcare field, or the equivalent combination of education and experience is required.

Experience:

Experience in progressively responsible positions in healthcare or health plan environment, with a minimum of five years experience negotiating and implementing managed care contracts for hospitals, medical groups and/or HMOs.  Demonstrated experience developing and drafting language, contract review, including review for compliance, and network development and operations.  Experience with supervisory responsibilities of various staff is required.

Knowledge: 

Strong Knowledge of market imperatives and trends for healthcare providers.  Ability to perform managed care contract analysis, document language review, and support the development and maintenance of contract compliance.  Advanced knowledge of the operational implications of managed care contracts relative to both medical groups/IPAs and facilities. An in-depth understanding of all regulatory requirements for contracting and compliance as it relates to Knox-Keene, Department of Managed Health Care, CMS, HIPPA or ERISA.  As well as the ability to influence and facilitate senior executive teams as needed to ensure the effective management of complex, multi-faceted project management is required.  Skills with data base management and word processing are also required.

Special Skills/Equipment:

Demonstrated ability to negotiate Managed Care contracts and develop and draft contract language.  Ability to build consensus through effective communication skills, both written and oral.  Demonstrated ability to engage in positive, powerful persuasion with individuals or groups with diverse opinions and/or agendas; ability to influence and facilitate senior executive teams as needed to ensure the effective management of a complex, multi-faceted project is required.  Must be able to enlist cooperation and build teams committed to carrying out initiatives in environments that may be resistant to change and not under the incumbents direct authority.  Must have the ability to maintain a high level of energy and creativity as well as the ability to work independently, prioritize multiple objectives in a rapidly changing environment and deliver quality outcomes.  Must be able to develop and create reports or other presentations to executive teams.

Physical Requirements: