Search Page | Back to Results

Contract Administrator - Behavioral Health

Community Health Plan of Washington, a provider of Apple Health (Medicaid) coverage, is pleased to participate in Washington State's Fully Integrated Managed Care (FIMC) early adopter program which took effect on April 1, 2016. We have an exciting opportunity for a Contract Administrator with experience in Behavioral Health to join our Contracting team!

POSITION PURPOSE:
Accountable for developing, maintaining, and expanding the provider network and, conducting negotiations with various provider types.

PRINCIPAL DUTIES:
Essentials Functions:
Contract Negotiations
•Negotiates hospital, physician groups, ancillary provider, behavioral health, Long Term Support Services contracts, as well as, Care Coordination Organizations, Area Agencies on Aging serving Health Home initiatives in Washington State and other provider types as needed.
•Performs contracting negotiation using reimbursement strategies that are aligned with Community Health Plan of Washington objectives and meet the needs of the provider communities.
•Ensures provider negotiations and contracts are managed in a way that is in compliance with various regulatory agencies, i.e., OIC, HCA, and CMS.
•Assures maintenance of accurate, current, detailed files with important provider information.
•Proactively indentifies and addresses gaps in the provider network to improve patient access and meet Community Health Plan of Washington’s network adequacy requirements.
•Prepares and distributes necessary documents to complete the contracting process to operationalize contracts.

Maintain and Improve Contracted Provider Relationships
•Initiates and maintains productive long-term relationships with the provider networks allied systems, and other agencies such as mental health and substance use disorder agencies.
•Communicates proactively with other departments to ensure effective and efficient business results.
•Develops and uses effective cost and utilization reports for the administration of the contracted relationship.
•Leads teams of Community Health Plan of Washington subject matter experts to resolve provider specific and systemic operational issues.
•Participates and reviews Community Health Plan of Washington’s policies and procedures that impact provider relations and contracting.
•Responds effectively to HCA and OIC complaints submitted by providers.
•This position involves traveling on behalf of the Company. It is essential that a current driver’s license, an acceptable driving record, and proof of automobile are maintained.

Other Functions:
•Other duties as assigned.

QUALIFICATIONS:
Education:
•Bachelor’s degree (in Business Administration, Finance, or related field) or a combination of education and highly relevant experience required.

Prior Related Experience
•Minimum 2 years of contracting and/or contract management in Managed Care required.
•Minimum 4 years contracting and servicing providers in an insurance setting, hospital, Behavioral Health environment, or other clinical settings preferred.
•Knowledge and Experience with Health Homes in Washington State
•Experience with risk arrangement and, value based purchasing

Employment Eligibility
•Candidate has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.

Knowledge, Skills, and Abilities
•Requires knowledge and experience in contract negotiations with various reimbursement methodologies such as fee for service and capitation.
•Must be able to maintain current contracting strategies in a managed care setting.
•Maintains knowledge of state and federal regulatory requirements as it relates to provider contracting.
•Ability to meet scheduled deadlines with minimal supervision.
•Strong organizational skills and accurate work results.
•Proven track record of maintaining a professional appearance, demeanor and confidentiality.
•Excellent public speaking, written communication and problem solving skills.
•Ability to understand and communicate various services and products of Community Health Plan of Washington.
•Strong analytical and negotiation skills.
•Ability to work in a team environment.

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Time:  Full time
Salary:  Salary
Category:  Network management

Updated: 1/9/2017 2:28:10 PM

Job Contact:
Susan Ginsberg
2066138971

Send Resume

1111 Third Avenue
Seattle, WA 98101

2066138971