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Contract Negotiator

2 months ago

San Francisco, California, United States San Francisco Health Plan Full time
Job Summary

We are seeking a skilled Contract Manager to join our team at San Francisco Health Plan. As a Contract Manager, you will play a critical role in negotiating and implementing provider contracts and Letters of Agreement to sustain and build our network of clinics, medical groups, hospitals, and ancillary providers.

Key Responsibilities
  • Develop and manage provider contracting efforts and partnerships.
  • Support the development of contracting strategies based on new or existing initiatives and requirements.
  • Ensure all configuration changes pertaining to new or amended contracts are implemented in a timely and accurate manner.
  • Successfully negotiate the terms and conditions of contracts and other transaction documents, finding creative solutions to avoid and resolve potential contractual impasses.
  • Interpret and integrate regulatory changes into applicable provider agreements.
  • Monitor ad-hoc out-of-network service agreements to determine provider contract opportunities.
  • Communicate new and updated contract terms and rates to internal stakeholders.
  • Maintain effective working relationships with SFHP providers, vendors and medical groups, and internal staff.
  • Manage the Letter of Agreement queue.
  • Maintain and improve upon document organizational models to serve the contracting team's objectives.
Requirements
  • 3 or more years of experience in healthcare provider contracting in a managed care setting.
  • BA/BS in Business, Healthcare or related field.
  • Knowledge of managed care, Medi-Cal and other entitlement programs.
  • Knowledge of health plan administrative requirements, delegation, and diverse reimbursement models.
  • Exceptional ability to communicate effectively, deliver presentations and lead diverse groups.
  • Experience with healthcare data for the purposes of contract negotiations.
  • Ability to understand legal terms typically found in managed care agreements.
  • Experience with data gathering, analysis specifications, and data/report analysis.
What We Offer
  • Health Benefits
    • 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.
About SFHP

Established in 1997, San Francisco Health Plan (SFHP) is an award-winning, managed care health plan whose mission is to provide affordable healthcare coverage to the underserved low and moderate-income residents in San Francisco County. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services.

San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

San Francisco Health Plan is an E-Verify participating employer.

Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.