Ensure provider contract terms and rates are propagated through multiple systems
Ensure synchronization and validation of contract terms into the Contracts, Authorizations, and Claims databases
Facilitate a seamless implementation process for providers
Conduct thorough audits of rates within databases to guarantee accuracy
Coordinate with third-party software vendors to articulate requirements, develop, and test solutions for effective implementation of business processes
Serve as the primary finance liaison with internal compliance department
Collaborate with external provider networks for essential data elements and formats
Verify payment information is correctly captured and integrated
Maintain clear communication and coordination with external partners
Work with IT department to obtain, develop and integrate automated files from contracts
Ensure amendments are accurately reflected in the system
Perform and oversee regular audits of the claims system to ensure accuracy
Ensure discrepancies in provider contract rates are promptly identified and corrected
Review monthly CMS precluded provider list and notify other areas of business
Collaborate with Claims and Authorizations senior leadership to align strategies and decisions with organization goals and regulatory requirements
Actively participate in the development and testing phases of software solutions.

Bachelor's degree required
Equivalent years of relevant work experience may be accepted in lieu of required education
Three (3) years of healthcare operations or contracting experience required
Expert proficiency in databases and Excel
Ability to meet multiple deadlines timely and accurately
Ability to anticipate, recognize and resolve issues
Ability to clearly and concisely articulate issues
High level of attention to detail and accuracy
Strong critical thinking and reasoning skills
Ability to work well with multiple disciplines
Excellent communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders
Strong analytical thinking and problem solving skills.

Senior Contract Manager

Key skills