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Job Details

Contract Manager

Company name
San Francisco Health Plan

Location
San Francisco, CA

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Profile

Overview
 
POSITION SUMMARY
 
The Contract Manager, under the general direction of the Director of Provider Network Operations works collaboratively with the rest of the Contracts and Provider Relations teams, assists with negotiation and implementation of SFHP\u2019s primary network clinic, medical group, hospital, and ancillary provider contracts.  The Contract Manager works collaboratively with both external providers of health care services and internally as necessary to establish new long-term agreements.  This person may also be called upon to resolve contract related issues that arise between any manner of internal or external customers.  
 
WHAT YOU\u2019LL DO

Develops and manages provider contracting efforts and partnerships.
Leads or assists Director with the development of contracting strategies based on new or existing initiatives and requirements
Responsible for ensuring all configuration changes pertaining to new or amended contracts are implemented in a timely and accurate manner.
Successfully negotiates the terms and conditions of contracts and other transaction documents, finding creative solutions to avoid and resolve potential contractual impasses.
Monitors ad-hoc out-of-network service agreements to determine provider contract opportunities.
Communicates new and updated contract terms and rates to internal stakeholders.
Leads the contract templates and amendments development process.
Maintains effective working relationships with SFHP providers, vendors and medical groups, and internal staff.
Provides training to internal partners on contracting efforts, needs, and process.
Responsible for ongoing communication to Director, PNO about key projects, goals, challenges and barriers to assure timely and effective issues escalation.
Assists with assignment and monitoring of work of department Coordinator.

WHAT YOU\u2019LL BRING

BA/BS in Business, Health Care or related field with two years of work experience or Master\u2019s Degree in Business, Health Care Administration or related field with one year of experience is required
Experience in health care provider contracting in a managed care setting is required; ability to understand legal terms typically found in managed care agreements
Prior experience in a managed care plan or health care provider organization is required
Knowledge of claims system configuration practices is preferred
Project management experience is preferred
Knowledge of Microsoft Access and Visio is preferred as well as some background in data analysis
Ability to analyze health care data for the purposes of contract negotiations
Ability to communicate effectively (spoken and written), give presentations and lead diverse groups (staff, management and executives, etc.)
Familiarity with health care, managed care and its terminology, or Medi-Cal and other entitlement programs is strongly preferred.
Detail oriented and organized with the ability to interpret policy and make recommendations.

 
 
ABOUT US
 
Established in 1997, San Francisco Health Plan (SFHP) is a an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. San Francisco Health Plan is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 142,000 members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.
 
San Francisco Health Plan is an Equal Opportunity Employer (EOE) M/F/D/V.
 
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records
 
 

Company info

San Francisco Health Plan
Website : http://sfhp.org/

Company Profile

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