Senior Contract Manager

5 days ago


San Francisco, California, United States San Francisco Health Plan Full time
Senior Contract Manager Job Description

At San Francisco Health Plan, we are seeking a highly skilled Senior Contract Manager to join our team. As a key member of our Contracts Management department, you will play a critical role in leading the negotiation and implementation of provider contracts with our network of clinics, medical groups, hospitals, and ancillary providers.

Key Responsibilities:
  • Develop and manage provider contracting efforts and partnerships.
  • Lead the development of contracting strategies based on new or existing initiatives and requirements.
  • Ensure all configuration changes with new or amended contracts are implemented accurately.
  • Acquire and maintain claims processing system knowledge to ensure all configuration changes to new or amended contracts are implemented.
  • Successfully negotiate the terms and conditions of contracts and other transaction documents, finding creative solutions to avoid and resolve potential contractual impasses.
  • Monitor ad-hoc out-of-network service agreements to determine provider contract opportunities.
  • Communicate new and updated contract terms and rates to internal stakeholders.
  • Lead the development of contract templates and amendments.
  • Participate in and support enterprise-wide projects to implement new benefits and products.
  • Analyze health care data for the purposes of contract negotiations.
Requirements:
  • 5+ years experience in healthcare provider contracting in a managed care setting.
  • 3+ years experience with Medi-Cal and/or Medicare in a managed care setting.
  • 3+ years of direct provider contract negotiation experience.
  • BA/BS in Business, Healthcare or related field.
  • Experience with analysis of healthcare data for the purposes of contract negotiations.
  • Comprehension of legal terms typically found in managed care agreements.
  • Experience with data gathering, and data/report analysis.
  • Detail oriented and organized with the ability to interpret policy and make recommendations.
  • Knowledge of Microsoft Access and Visio.
What We Offer:
  • Medical: You'll have a choice of medical plans, including options from Kaiser and Blue Shield of California, heavily subsidized by SFHP.
  • Dental: You'll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
  • Vision: Employee vision care coverage is available through Vision Service Plan (VSP).
  • Retirement: Employer-matched CalPERS Pension and 401(a) plans, 457 Plan.
  • Time off: 23 days of Paid Time Off (PTO) and 13 paid holidays.
  • Professional development: Opportunities for tuition reimbursement, professional license/membership.


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