Job Overview:
We are seeking an experienced and skilled Medicaid Contracts Manager to join our team. As a key member of our organization, you will be responsible for managing and overseeing the Medicaid Contract Unit, ensuring the effective management of contracting data, and providing support activities necessary for the success of our department.
Key Responsibilities:
- Manage payor contracts, including negotiation and renegotiation of new and existing contracts
- Collaborate with the Provider Enrollment and Maintenance team to ensure timely implementation and auditing of contracts
- Develop, coordinate, and analyze payor contracts, ensuring compliance with company templates and reimbursement structure standards
- Negotiate payment terms and rates, resolving escalated contract-specific issues and providing coaching to Contracts staff
- Establish and maintain strong business relationships with assigned providers and internal partners, influencing forecasting and planning activities for network growth
- Design and produce reports for internal and external recipients, compiling and analyzing contract data for audit review and quality improvement
What We Offer:
- Competitive compensation and benefits package, including annual incentive bonus plan, medical, dental, and vision insurance, and generous vacation and sick time accrual
- Opportunity to work with a leading healthcare organization, making a meaningful impact on the lives of our patients and communities
- Flexible work arrangement, with remote option available, and a dynamic work environment that fosters growth and development
- Professional development opportunities, including training and education programs, to enhance your skills and knowledge
Requirements:
- Undergraduate degree or three years of network management-related work experience, with at least three years of experience in a network management-related role handling complex network providers
- At least three years of experience with direct provider contracting, including facility, physician, and ancillary providers, and experience with client-facing responsibilities, including issue resolution and contract negotiations
- Strong knowledge of data extraction methodologies, ability to present complex data and information to varying audiences, and excellent computer skills, including proficiency in Microsoft Office Products
- Must reside in North Carolina or within 40 miles of the NC border
Preferred Qualifications:
- Paralegal background preferred, with at least five years of experience with direct provider contracting, including facility, physician, and ancillary providers
- Experience in healthcare, especially public behavioral health, managed Medicaid, and healthcare payor systems and law
Take the Next Step:
Are you ready for this challenge? Apply now and let’s discuss how you can become a vital part of our success story.
