Contract Officer

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New Haven, CT
Feb 12, 2019

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Job Description

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

EEO/AA/Disability/Veteran

Summary:

This position is a senior managed care position and
responsible for overseeing health plan contracting, contract implementation and
ongoing contract management for assigned Payers and entity relationships. The
position deals with external constituents, including managed care payers,
employers, third party administrators and insurance companies, as well as
internal constituents within the Yale-New Haven Health System and/or the Yale
School of Medicine. Contracts are negotiated and coordinated in conjunction
with the VP, Payer Strategy and Innovation and with appropriate representatives
of the Yale School of Medicine.

Responsibilities:

  • 1. Negotiates with managed care organizations and/or
    insurers to obtain provider services agreements that advance the profitable
    growth of Yale New Haven Health System and/or Yale School of Medicine. Many
    agreements are negotiated directly by incumbent. Several major agreements may
    be negotiated in conjunction with the VP, Payer Strategy and Innovation and/or with
    representatives of the Yale School of Medicine.

    2. Ensures that provider agreements can be supported and key
    deliverables or performance targets upheld in advance of committing the
    organization to their terms. Upon receipt of proposed contracts, performs objective
    data analysis to ensure completeness and financial acceptance with agreed upon
    terms.

    3. Responsible for proactively managing timeframes for
    contracts and obtaining fee schedule changes and contract terms in a timely
    manner for new contracts and at or prior to contractual renewal date for
    contract renewals.

    4. Responsible for delivering critical information
    concerning covered services, par providers, carve-outs and fee schedules to
    affected internal clients in a timely manner; facilitates clear and unequivocal
    communications between contractors and health system clientele as necessary to
    ensure smooth implementation of agreements.

    5. Maintains a keen awareness of the external business
    environment and most -likely prospects for garnering new payer agreements
    and/or favorable payment provisions.

    6. Supports quality program initiatives and ensures that the
    relevant standards are upheld in all contracting ventures. Prepares and
    delivers comprehensive presentations on managed care initiatives and status of
    agreements to various Yale New Haven Health System and Yale School of Medicine
    constituents.

    7. Strategically assess and develops managed care
    opportunities to improve and solidify revenues. Leads assigned teams to address
    major projects involving the development of system wide initiatives in managed
    care contracting. Evaluates scope, plans and designs steps, timelines and
    foreseeable deliverables; writes supporting proposals and summarizes completed
    projects.

    8. Cultivates effective partnerships with internal
    stakeholders and colleagues to present a cohesive and proactive team approach
    to meeting client needs. Participates substantially on working teams from
    hospital, health system and Medical School to bring about seamless and
    consistent contracts beneficial to the providers across the spectrum of care.

    EDUCATION:

    Bachelors Degree (Masters Preferred) in
    business, public health, health care administration or related field.

    EXPERIENCE:

    Minimum of five to seven years
    contracting experience in progressively responsible management roles within a
    health care setting.

    SPECIAL_SKILLS:

    Exceptional communication skills, both
    verbal and written. Ability to articulate complex issues via presentations to senior
    management. Solid understanding of managed care, payment approaches, risk and
    capitation and managed care financial models. Demonstrated skills in data
    analysis and reporting. Excellent negotiation and partnering skills. Ability to
    make tough decisions with confidence. Ability to deal with ambiguity.
    Operational understanding of planning and marketing, finance, business office
    systems, human resources, hospital operations and medical staff leadership.
    Political savvy, strong ethics and teamwork skills. Accountable and
    self-directed with appropriate engagement of leadership support.
    *CB
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    Job Info

    Job: 2292

    Department: Managed Care Division
    Category: Non - Clinical Other
    Hours: 40.00

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