Contract Administrator

Role Overview

• The Contract Administrator manages all administrative and procedural components of provider contracts (Medicaid and Non-Medicaid) throughout the contract lifecycle, including but not limited to ensuring compliance with company contract templates, standards, and other key process controls
• This includes implementation, completion and ongoing follow-up of various managed-care contracts, amendments, and other related document for entities within Alliance Health’s integrated delivery system
• Assist in development and maintaining effective relationships with payors and internal stakeholders
• Communicate contract terms and/or facilitate follow up with General Counsel to providers and work with other internal departments to implement improvements in the contracting process
• Manage the full life cycle of provider contracts, including timely preparation of contract documents while giving special attention to language and accuracy, dissemination of contracts to providers within MCO-identified timeframes, follow-up of agreement status to ensure full execution, as well as accurate processing of executed contracts including completing all required organization forms, checklists, and data entry
• Review any modifications, confirm executed contractual terms and conditions meet MCO requirements, and confirm all attachments are complete
• Ensure contract elements are loaded correctly, timely and meet legal and business standards
• Interface with IT Department to ensure data integrity and accuracy of contract details and ensure all required data elements are entered into the Alliance Claims System
• Create the provider profile in accordance with all services the provider is contracted to provide, and ensure all appropriate rates are included; data must be accurate and timely to support claims processing
• Provide guidance and technical assistance to Alliance providers regarding the processing of contracts as well as ongoing resolution of any contract-related issues
• Help to address provider questions and complaints related to contracting issues and engage Provider Network Relations Staff as needed
• Investigate consumer/provider service discrepancies in contract details as requested and report findings
• Organize, maintain and electronically track all contract and related documents
• Ensure the contract database system functions properly to serve Alliance needs and prepare and distribute reports to facilitate planning and maintenance of accurate contract records and files
• Manage contract files per department procedures and participate in development of time-phased plans for renewal of contracts to support anticipated requirements
• Work collaboratively with cross-departmental staff members to ensure contract deadlines are met and resolve contract-related issues
• Establish and maintain strong business relationships with Hospitals, Physician Groups, LIPs and Ancillary providers.

Requirements

• Graduation from a four-year college or university and three years’ experience in contracts administration, or administrative management, preferably involving participation in the planning and management in a behavioral healthcare agency, activity or specialized program
• A Master's Degree in a relevant program area may be substituted for two years of the required experience
• At least two years of experience working in a Health Care, Managed Care, LME/MCO or Business setting that requires administrative, project oversight or leadership responsibility
• Thorough knowledge of contracting procedures
• Understanding of federal and state law, rules, regulations, guidelines, policies, and procedures applicable to LME-MCO contracting
• Knowledge of planning and scheduling techniques
• Working knowledge and understanding of computer-based contract maintenance programs
• Skill in organizing resources and establishing priorities
• Ability to work effectively with a wide range of individuals and groups in a diverse community
• Skill in computer use and database management
• Ability to organize and coordinate programmatic contract implementation
• Ability to gather and analyze statistical and financial data and generate clear and comprehensive reports
• Ability to make sound judgments and decisions on sensitive matters
• Ability to build consensus, develop collaborative work plans and implement planned activities
• Ability to understand LME-MCO requirements, goals, targets and outcomes
• Ability to interpret administrative direction, communicate effectively to a diverse audience, manage diverse tasks simultaneously, and exercise discretion with confidential information
• Excellent written and verbal communication skills; ability to communicate effectively with a variety of groups and individuals
• Ability to establish and maintain effective working relationships with senior staff, LME-MCO staff, providers, community groups, and local and state agencies.

Benefits

• Medical, Dental, Vision, Life, Short and Long
• and Short-Term Disability
• Generous retirement savings plan
• Flexible work schedules including hybrid/remote options
• Paid time off including vacation, sick leave, holiday, management leave
• Dress flexibility