CCRM Management Company, Lone Tree, CO, US
Today Requisition ID: 1298
Salary Range:$65,000.00 To 70,000.00 Annually
As a key member of CCRM Payer Strategy team, this position is responsible for managing contracts for the Payor Strategy Team and consists of administrative and technical work in the development, negotiation, and implementation of contract terms, and monitoring contractual agreements. The Contract Manager is expected to be an individual contributor and will be responsible for coordination of all aspects of the contracting process. Key factors include assertively supporting company growth by developing new contracts with payers and expanding services with payers that have existing contracts. The position supports the entire contract process and closely collaborates with internal departments to ensure staff are informed of new contracts, changes to existing contracts and updates to the medical and billing policies of the payers.
What You’ll Do Every Day
- Perform full life-cycle Contract Management for a large portfolio of high value contracts. Provide technical expertise in developing, organizing and processing contracts. 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
- Assist with all contracting administration and projects, as needed.
- 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, identifies and implements 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.
- Maintain excellent written and verbal communication with all internal and external customers.
- Effectively and professionally, represent CCRM to the payer, provider and patient community.
- Perform other duties, as assigned.
This job description is not designed to cover or contain a comprehensive listing of activities, tasks, duties, or responsibilities that are required of this position. Duties, responsibilities, tasks, and activities of this position are subject to change at any time with or without notice.
Required Knowledge, Skills and Abilities
- Strong demonstrated knowledge and understanding of healthcare industry, legal and regulatory requirements.
- Exceptional and proven provider partnership skills and interpersonal skills.
- Ability to develop and deliver presentations to internal and external groups.
- Demonstrated strength in computer software, e.g., MS Office Suite, PowerPoint, social media and internet-based research.
- Ability to review, interpret, analyze, manage, and negotiate complex agreements and resolve contractual issues.
- Results driven, persistent, able to self-direct and work independently showing initiative, while seeking guidance when appropriate.
- Ability to multi-task, pay close attention to detail and be flexible in a fast paced and growing organization.
- Strong organizational and analytical skills.
- Excellent contract negotiation skills.
Education and Experience
- Minimum of 3 years of relevant experience with hospital, clinic, physician, and or health system contracting -Bachelor’s Degree or equivalent experience.
- Experience working at a medical insurance company, MSO, IPA, TPA highly preferred.
- Prolonged periods of sitting at a desk and working on a computer.
- Prolonged period of preparing and analyzing data and figures.
- Ability to occasionally lift up to 15 pounds.
- Professional office environment with daily use of standard office equipment such as computers, telephones, photocopiers, and scanners.
Why Join CCRM Fertility?
As one of the leading providers of fertility services in the nation, CCRM is comprised of the best people in the industry. If you have a desire to be a part of an enthusiastic team, help patients achieve their dreams of parenthood, and grow both professionally and personally, CCRM may be the right place for you. CCRM offers competitive pay and benefits, growth opportunities, and an environment supportive of the success of our teams.
What we Offer our Team Members
· Competitive pay and bonus opportunity
· Medical, dental and vision benefits
· 401(k) with Company match
· Paid time off and holiday time
· Professional development opportunities
· Job training and cross training opportunities
$65,000.00 - 70,000.00 per year, paid bi-weekly plus bonus potential
Actual compensation offered will be determined based on the selected candidate’s skills, education, and experience.
All offers of employment are conditional upon successful completion of pre-employment screenings, including a criminal background check, drug screen, professional reference checks, and verification of your eligibility and authorization to work in the United States. Some positions may also require verification of your education, professional licensure and/or certifications, and prior employment.
Who Is CCRM Fertility?
CCRM Fertility is a global pioneer in fertility treatment, research and science. Founded by Dr. William Schoolcraft 35 years ago, CCRM Fertility specializes in the most advanced fertility treatments with deep expertise in IVF, fertility testing, egg freezing, preimplantation genetic testing, third party reproduction and egg donation. CCRM Fertility leverages its own data and a dedicated team of in-house reproductive endocrinologists, embryologists and geneticists to deliver industry-leading outcomes.
CCRM Fertility has 34 locations in North America, serving patients in 12 major metropolitan areas, including Atlanta, Boston, Dallas-Fort Worth, Denver, Houston, New Jersey, New York, Northern Virginia, Minneapolis, Orange County, San Francisco Bay Area, and Toronto.
CCRM Fertility is a proud strategic partner of Unified Women’s Healthcare, a focused women’s health company that strategically operates, affiliates, or invests in business that drive better outcomes and experiences for patients for every milestone and moment of her healthcare journey. For more information, visit www.ccrmivf.com.
We are an equal opportunity employer. In all aspects of employment, including the decision to hire, promote, discipline, or discharge, the choice will be based on merit, competence, performance, and business needs. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.