Contract Management Specialist

1 week ago

Albion, United States Boone County Health Center Full time

Job Summary: Boone County Health Center is seeking an experienced and motivated Contract Management Specialist to manage the development, negotiation, and ongoing maintenance of all payer contracts. In this role, you will work closely with the CEO, CFO, and internal departments to support the Health Centers growth by establishing new payer relationships, expanding existing contracts, and ensuring alignment with financial and regulatory goals. This position offers a unique opportunity to directly impact the growth and financial health of the organization. The ideal candidate will have strong negotiation skills, a deep understanding of the healthcare industry, and the ability to collaborate effectively across departments.

Key Responsibilities:

Contract Development and Negotiation:

  • Develop, negotiate, and maintain contracts with various payers, including insurance companies, MSOs, IPAs, TPAs, and government programs.
  • Identify opportunities to expand services with existing payers and explore new markets to increase payer participation.
  • Ensure contracts meet financial targets and comply with legal and regulatory requirements.
  • Analyze cost and utilization data to drive negotiations and ensure favorable terms for Boone County Health Center & Clinics.

Contract Management and Compliance:

  • Oversee the entire contract process from pre-contract through post-signature, including facilitating approvals and ensuring timely execution.
  • Ensure all contract documentation is accurate and complete, maintaining high standards of compliance and accuracy.
  • Develop processes for tracking critical contract milestones, including renewals, terminations, and other key deadlines.
  • Work with the billing department to communicate and implement changes in medical policy and billing practices as outlined in payer contracts.

Relationship Management:

  • Maintain positive relationships with existing contracted providers, ensuring the terms of agreements are up-to-date and that fee schedules are evaluated regularly.
  • Collaborate with internal teams to ensure smooth implementation of new contracts and contractual amendments.
  • Provide ongoing support for contractual issues, including monitoring network performance and addressing concerns with payers and providers.

Strategic Planning and Reporting:

  • Participate in strategic business planning with the Administration Team, identifying growth opportunities and addressing gaps in the payer base.
  • Prepare and maintain regular reports (e.g., bi-weekly) on the status of contracts, ensuring key stakeholders are informed about progress and issues.
  • Recommend strategic initiatives to enhance contract value, including network assessments, service expansions, and policy updates.

Communication and Coordination:

  • Serve as the primary point of contact for both internal and external customers regarding contracts and contractual matters.
  • Effectively communicate contractual terms and changes to all relevant departments, ensuring staff are well-informed of updates that may impact billing and operations.
  • Represent Boone County Health Center & Clinics professionally in interactions with providers, payers, and industry stakeholders.

Additional Duties:

  • Assist with other contracting administration tasks and special projects as directed by the VP of Financial Services.
  • Stay up to date with industry trends, regulatory changes, and payer requirements to ensure contracts remain compliant and competitive.

Qualifications:

Education:

  • Bachelors degree or equivalent work experience in healthcare administration, business, or a related field.

Experience:

  • Minimum of 3 years of relevant experience in healthcare contracting, including experience with hospital, clinic, physician, and/or primary care contracting.
  • Experience in negotiating payer contracts, analyzing cost and utilization data, and managing contract lifecycle.
  • Experience in working with insurance companies, MSOs, IPAs, TPAs, or other healthcare-related entities is highly preferred.

Skills & Abilities:

  • Strong knowledge of the healthcare industry, including regulatory and legal requirements for payer contracts.
  • Exceptional negotiation skills and a proven ability to secure favorable terms for the organization.
  • Ability to multitask, manage competing priorities, and work independently in a fast-paced environment.
  • Strong organizational, analytical, and problem-solving skills.
  • Excellent written and verbal communication skills, with the ability to present complex information to internal and external stakeholders.
  • Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word) and ability to use various software tools for contract management and reporting.
  • Experience with Revenue Cycle Management (RCM) software preferred but not required.

Other:

  • Ability to work collaboratively with internal teams, including finance, billing, and operations.
  • Results-driven, with a strong sense of initiative and the ability to work independently.

Boone County Health Center is an equal opportunity employer and values diversity in its workforce. We encourage candidates from all backgrounds to apply. If you are an experienced contract professional with a passion for healthcare and organizational growth, we would love to hear from you

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