Job Purpose The Manager, Contract Management ensures that contract provisions are loaded, validated and maintained accurately by overseeing the daily operations of the department.
Duties and Responsibilities
- Oversees Managed Care Department for all the day to day operations
- Assists in the training of all staff both on the hospital side and Physician side
- Manages all internal and external customer support tickets for the Contract Management Department
- Manages staff for all contract loads and validations
- Assists AVP in the implementation of all new clients
- Communicates all contract changes made by the department to key departments. ex: AR valuation, AR Services, etc.
- Assists in the research for all new state government plans for new implementations
- Responsible for downloading and distributing all contracts we have access to retrieve from our clients Managed Care sites
- Pulls all government factors for pricing Medicare/Medicaid for all clients and distributes to be loaded and validated
- Responsible to maintain all contracts and fee schedules for both the Hospital side and Physician Billing side of the company
- Key communicator between Underpayment Group and CM to ensure all questions are addressed so UP team goes after valid underpayments
- Assists in validating new client data to ensure pricing is accurate
- Assists AVP of Managed Care in all special projects for both internal and external clients
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Qualifications
- Bachelor Degree preferred
- Minimum 5 years work experience with 3+ years of financial analysis or contract management experience
- Ability to interpret managed care contracts
- Must have government reimbursement understanding
- Advanced Excel knowledge
- Ability to thrive in a fast paced and dynamic work environment
- Excellent communication and presentation skills
- Revenue cycle management experience is preferred
Working Conditions
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
- Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
United States
