Senior Manager, Contracting - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 158398
JOB SUMMARY: The Senior Manager of Contracting will provide support to the Director of Contracting by assuring that Community achieves and maintains regulatory and accreditation compliance, as well as competitiveness, of its Provider networks for all lines of business (Medicaid/STAR, CHIP/CHIP Perinatal, Health Insurance Marketplace and others as determined by Community). This position is also responsible for contracting/re-contracting efforts or special projects, including but not limited to single case agreements, amendments, and service or product/program expansion. Manages and coordinates with all Community departments to ensure adequate set up and comprehensive interpretation of new contract fees and requirements. Assists with provider profiling, working closely with Finance, Analytics, Provider Relations, Member Services, Claims, and Medical Affairs to provide reports, assist with analysis and recommend actions. Requests, reviews, and analyzes quantitative analysis of various types of data including provider contracts, fee schedules, utilization and claims data needed for assessing, planning, budgeting, cost control and contract administration and makes recommendations for contracting rates and policies. Manages and helps mentor the staff that negotiate/maintain physician, hospital, ancillary and integrated health system contracts.
1. Education/Specialized Training/Licensure:
4 years equivalent work experience may substitute for degree requirement.
2. Work Experience (Years and Area):
5+ years in the following areas: managed care with at least 3 years experience in contracting with physicians, ancillaries, hospitals.
Experience in value based contracting a plus.
3. Management Experience (Years and Area):
Minimum 3+ years
4. Equipment Operated: Computer, fax, scanners, MS Office, company-specific systems
SPECIAL REQUIREMENTS: Communication Skills: Above Average Verbal (Heavy Public Contact) Writing /Composing, Correspondence Reports
Other Skills: Analytical , Medical Terms, Statistical, P.C. , MS Word, MS Excel
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.