12 days old

Director, Managed Care Contracting

Umpqua Health
Roseburg, OR 97470
Apply Now
Apply on the Company Site
  • Job Code
    124777796
Full Time - Regular
Roseburg, OR, US


POSITION PURPOSE

This position will prepare, review, monitor or maintain provider contracts, leases and other contractual agreements; ensure compliance of applicable rules and regulations; research and prepare reports as needed; and serve in an administrative capacity for all contract matters.

ESSENTIAL JOB RESPONSIBILITIES
  • Responsible for CCO VBP contract proposals and reporting.
  • Partner with Quality and Network Operations as needed.
  • Produce proposals for contract rates and value based care (VBC) arrangements, along with reporting framework and benchmarks.
  • Analyze and report CCO VBP performance, partnering with Quality, and coordinating with Finance re: appropriate contract accruals.
  • Manage contracting staff.
  • Collaborate with the Finance and Data Support Departments in identifying contracting and network development strategies.
  • Work with Network Operations and Leadership in designing, developing and negotiating provider contracts, including identifying alternative payment methodologies.
  • Maintain contracts in accordance with appropriate record retention procedures and internal controls.
  • Develop and prepare performance specifications and requests for proposals.
  • Establish schedules and methods to ensure contract compliance, including required timely payments, and document management. Review needs with management for allocation.
  • Participate in the development of policies and procedures. Make recommendations for change and improvements to existing standards and procedures.
  • Provide various agreement information to potential tenants, consultants, contractors, developers, legal counsel and other external entities.
  • Prepare and complete required agreement information, documents, drafts and amendments. Enter information into computer system, prepare correspondence for approval, and validate contract assignments.
  • Manage the interface and related workflows with external legal counsel and external legal specialists.
  • Collaborate with Umpqua Health's Compliance Department on matters pertaining to contract compliance and vendor performance.
  • Prepare analytical and statistical reports on operations and activities, as applicable.
  • Attend and participate in professional group meetings as needed.
  • Lead Network Performance Committee and collaborate with Network Operations Manager.
  • Comply with organization's internal policies and procedures, Code of Conduct, Compliance Plan, along with applicable Federal, State, and local regulations.
  • Other duties as assigned.

QUALIFICATIONS
  • Bachelor's degree with major coursework in business administration or a related field + 2 years of contract development, contract management or related experience.
  • Principles and practices of research, analysis and report preparation. Able to prepare clear and concise reports.
  • Oversight, principles and practices of contract compliance.
  • Strong English usage, spelling, grammar and punctuation.
  • Knowledge of pertinent Federal, State and local laws, codes and regulations.
  • Ability to interpret and explain Oregon Health Authority policies and procedures, experience with Oregon Health Plan preferred.
  • Excellent verbal and written communication skills as well as outstanding problem solving, organizational, and leadership skills.
  • Proven strong project management, multi-tasking and presentation skills.




PI124777796
Posted: 2020-10-12 Expires: 2020-11-13

Job Opportunities

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

Director, Managed Care Contracting

Umpqua Health
Roseburg, OR 97470

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast