Contract Manager

• Perform full life-cycle Contract Management for a large portfolio of high value contracts.
• Provide technical expertise in developing, organizing, and processing contracts and facilitate the approval process of all contract documents from pre-contract through post signature phases.
• Develop and maintain periodic, e.g., bi-weekly, reports on the status of all contracts.
• Collaborate on new practice transitions by researching territories to identify gaps with our payer base and supporting the expansion into new markets. Make recommendations regarding participation or non-participation with new or existing agreements.
• Review, interpret, analyze, manage, and negotiate complex agreements and resolve contractual issues.
• Adhere to all established contracting language and financial guidelines and parameters.
• Maintain and track financial performance for contracts and contract status. Monitor and coordinate financial analysis of payer contract performance and modeling projections.
• Utilize MedTrainer, Contract Works or other electronic tracking platform for repository, data collection, and reporting.
• Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes.
• Develop and maintain processes that provide timely notification of critical contract events (e.g., renewals, termination and due dates contained within the agreements).
• Maintain existing relationships with contracted providers. Ensure contractual language is current; evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes and reimbursement.
• Represents the organization in establishing business relationships with payers. Utilize communication and organizational skills to work collaboratively and credibly with payers to achieve common objectives.
• Collaborate with staff and contractors to ensure compliance with applicable laws and contract terms.
• Develop and maintain productive working relationships with project team members, partners, clients, vendors, and other key stakeholders.
• Maintain knowledge of federal, state, and county policies and legal requirements.
• Assist in producing and disseminating contract information to all relevant departments; assists to identify and resolve problems that arise with contracts including billing, claims payment, scheduling, registration, credentialing, service development, and care management, noncompliance.
• Respond to third party payers, employers, internal staff and physicians in day-to-day customer service relations and problem resolution.
• Collaborate with operational departments, identify, and implement appropriate changes in operating procedures and systems that might be required to accommodate payer contracts.
• Incorporate strategic business goals as presented by the CCRM Senior Leadership Team.
• Coordinate and communicate contractual terms to the billing department; ensure staff is informed of changes in medical policy & billing policies.
• Effectively and professionally, represent CCRM to the payer, provider, and patient community.
• Other duties as assigned.

• Bachelor’s Degree or equivalent experience required.
• 3+ years’ contracting experience with hospital, clinic, physician, and or health system required.
• Previous experience in IVF and Infertility medicine.
• 1+ year experience with medical insurance company, MSO, IPA, TPA, preferred.
• Competent in healthcare industry, legal, and regulatory requirements required.
• Excellent contract negotiation skills.

• Health Coverage

Medical, dental, and vision plans, fertility benefits, and supplemental insurance options.

• Paid Time Off

• Financial & Retirement Planning

401(k) with employer contribution, plus Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs).

• Income Protection

Short- and long-term disability, paid parental leave, basic life insurance, and optional additional coverage.

• Wellbeing Support

Employee Assistance Program, commuter benefits, pet insurance, and identity theft protection.

• Professional Development

Opportunities and resources to support your career growth.