Manager, Contract

Brief Description
Job Overview

Tango is a leader in the home care health management industry and is preparing for significant growth Tango is looking for an experienced healthcare contractor to act as our Contract Manager.

Tango manages the home health benefit for major insurance plans with a focus on Medicare Advantage and managed Medicaid members. We review home health care referrals for appropriateness, then set up services with multiple agencies to provide the care needed for patients. On an ongoing basis, we provide review and oversight of clinical care and determine further authorizations. Our delegation agreements often include credentialing home health agencies and paying home health claims.

This role will report into the Director of Contract Management to support the strategic growth and maintenance of our home health provider network. The Contract Manager is responsible for negotiating contracts for the expansion of our home health network and the ongoing management of the existing network across multiple geographies. In addition, the Contract Manager will provide leadership and oversight to assigned Contract Administrators to ensure effective execution of contracting activities and operational support. The Contract Manager will also be tasked with enhancing the existing network through value-driven contracting, provider performance, and relationship management.

Responsibilities

• Negotiate fiscally responsible, fee for service, episodic and value-based contracts with language that supports Tango's business model, payer agreements, and mission to provide high quality home health and post-acute services.
• Provide leadership, mentorship, and oversight to assigned Contract Administrators to ensure quality, accuracy, and timely execution of contracting activities.
• Ensure provider contracts meet Tango's compliance policies, Medicare guidelines, State and Federal laws and regulations.
• Negotiate and execute Letters of Agreement, Amendments to the Contracts and renegotiation requests.
• Develop and report out key network performance indicators in a continual effort to achieve network optimization, adequacy, and other key network strategies.
• Propose and execute on opportunities to improve network performance metrics.
• Track and monitor value-based arrangements tied to provider contracts by building reports and working with the finance team.
• Meet with contracted providers on a quarterly basis to review performance.
• Assist with network builds across various geographies with support from credentialing, provider specialist(s), and management teams, as needed.
• Work interdepartmentally to ensure contracts are loaded accurately and in a timely manner.
• Identify and propose opportunities to better streamline existing processes.
• Recruit and educate out of network providers on Tango's business model in an effort to create greater access to existing markets.
• Carry out network management assignments and other duties as directed by the management team.
• Provide support and guidance to internal teams on contract-related items.
• Review and analyze contract terms, identify potential risks and opportunities.

Ideal Candidate

• Excellent interpersonal skills
• Highly organized with strong written and verbal communication skills
• Well versed in navigating the nuances of ancillary provider contract negotiations
• Some experience negotiating value driven payment concepts.
• Ability to build trust and assurances with various partners and stakeholders both externally and internally.
• Proven ability to effectively problem solve and diffuse difficult situations in a timely manner
• Natural curiosity to learn and grow within a fast-paced organization.
• Proficient in Microsoft Excel and navigating large data files.
• General understanding of value-based metrics and gap closures
• Experience building and monitoring reports.
• Excellent organizational and time management skills
• Strong attention to detail

Education

• Requires a BA/BS
• Masters preferred.

Requirements

• Minimum 3 years' experience in an ancillary provider contracting role on a state level; multi-state level preferred.
• Must have knowledge of home health agency contract structure.
• Must have knowledge of PDGM payment modeling.
• Must have experience with alternative payment models and value-based arrangements.
• Must have a strong understanding of home health agency credentialing process.
• Must have a strong working knowledge of home care's role in the post-acute care space.
• Ability to travel on a quarterly basis, at minimum.

tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.