Lead Contract Manager - Transplant Contracting Experience Required - 100% REMOTE

JOB SUMMARY:
Provides leadership in securing optimal reimbursement and protecting the interests of the organization in contract negotiations, implementation, and management of managed care relationships. Contributes to strategy implementation and negotiations with multi-market health plans and physicians to increase the value of services provided.


KEY RESPONSIBILITIES:

• Responsible for the financial analysis, maintenance, negotiation, renegotiation, and management of agreements and contracts with purchasers of healthcare services.
• Plans, prioritizes, collaborates and communicates information regarding projects, issues, and negotiations to ensure relationships are maintained.
• Negotiates contracts with payors based on strategic and financial goals, prior contract performance, projected contract performance, and thresholds.
• Analyzes and finalizes contractual language for operational and financial appropriateness.
• Develops and maintains internal education communication processes and other tools to enhance contract performance, identification and compliance.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

TECHNICAL CAPABILITIES:

CONTRACT NEGOTIATIONS (EXPERT):- Demonstrates an understanding of negotiating skills such as building trust, gaining commitment, managing the opposition and maintaining goodwill. Realizes the need for mutual concessions and accommodations and negotiates with others for resources, actions or buy-in to maximize collaborative outcomes.

NETWORKING (EXPERT):- Build relationships through industry contacts, professional organizations and individuals.

REGULATORY COMPLIANCE (EXPERT):- Demonstrates knowledge of the appropriate rules and regulations and apply them in difficult, stressful and complex situations. Able to interpret and explain rules and regulations that are ambiguous or unclear. Directs others in interpreting rules and regulations on the job and trains others in them.

COMMUNICATION (EXPERT):- Clearly, effectively and respectfully communicates to employees or customers.

FINANCIAL ANALYSIS (EXPERT):- The process of evaluating businesses, projects, budgets, etc. to determine their performance, stability and profitability.

FINANCIAL MODELING (ADVANCED):- Building abstract representations of current and future financial situations in order to make sound financial recommendations.

CORE ACCOUNTABILITIES:

• Organizational Impact: Delivers projects/assignments that have a direct impact on goals/objectives of the unit/department that the job is in.
• Problem Solving/ Complexity of work: Conducts extensive analysis of situations or data to resolve numerous, complex issues; may involve the input/work of others.
• Breadth of Knowledge: Has in-depth level of knowledge within a professional area and working knowledge of other areas.
• Team Interaction: May lead mid-sized projects; coaches and guides team members.

CORE CAPABILITIES:

SUPPORTING COLLEAGUES (P4):

• - Develops Self and Others: Invests time, energy and enthusiasm in developing self/others to help improve performance and gain knowledge in new areas.
• - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.
• - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences.

DELIVERING EXCELLENT SERVICES (P4):

• - Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.
• - Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.
• - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness.

ENSURING HIGH QUALITY (P4):

• - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.
• - Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them.
• - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring.

MANAGING RESOURCES EFFECTIVELY (P4):

• - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.
• - Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.
• - Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities.

FOSTERING INNOVATION (P4):

• - Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches.
• - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.
• - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

Physical Requirements/Strengths needed & Physical Demands:


• Sedentary category requiring exertion up to 10 lbs. of force occasionally and uses negligible amounts of force to move objects. Sedentary work involves sitting most of the time.


Movement


• Occasional: Standing: Remaining on one's feet without moving.
• Occasional: Walking: Moving about on foot.
• Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another
• Occasional: Carrying under 35 lbs: Transporting an object holding in hands, arms or shoulders, with help of coworkers or assistive device.
• Occasional: Push/Pull: Exerting force to move objects away from or toward.
• Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles
• Occasional: Reaching above shoulders: Extending arms in any direction above shoulders.
• Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.
• Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.
• Occasional: Bimanual Dexterity: Requiring the use of both hands.
• Frequent: Sitting: Remaining in seated position
• Frequent: Fingering: Picking, pinching, gripping, working primarily with fingers requiring fine manipulation.


Sensory


• Continuous: Communication: Expressing or exchanging written/verbal/electronic information.
• Continuous: Auditory: Perceiving the variances of sounds, tones and pitches and able to focus on single source of auditory information
• Continuous: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision.


Environmental Conditions