Senior Contract Manager - Managed Care

                    

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

                        

We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

                                    

Job Title

Senior Contract Manager - Managed Care

                        

Location

Cleveland

                    

Facility

Remote Location

                     

Department

Ohio Market Finance-Finance

                      

Job Code

T34033

                     

Shift

Days

                       

Schedule

8:00am-5:00pm

                       

Job Summary

                         

Job Details

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world.   

As a Senior International Contract Manager, you will negotiate contracts on behalf of CCF within an assigned business area, evaluate new business opportunities, and manage the administrative, legal, operational, and financial aspects of contract negotiations. In this role, you will contribute to contracting strategy development, including business planning and implementation.

A caregiver in this position works remotely from 8:00 a.m. -- 5:00 p.m.

This role is required to meet with the team annually in Cleveland for a half-day, on-site meeting. Seeking candidates who reside in Ohio, Florida or Nevada.

A caregiver who excels in this role will:  

• Negotiate contracts on behalf of CCF within assigned business area.

• Evaluate new business opportunities.

• Manage administrative, legal, operational and financial issues related to contact negotiation.

• Participate in contracting strategy development including business planning and implementation issues.

• Prepare, coordinate and manage contract negotiation process.

• Identify and evaluate opportunities and financial terms for assigned contracts.

• Assess potential legal risk in the context of contract provisions.

• Develop appropriate legal and financial contract language.

• Coordinate and participate in legal review.

• Prepare responses, letters of agreement and key contract provisions.

• Prepare and implement strategies for business growth.

• Identify and target specific areas for development.

• Initiate and develop relationships.

• Track history and progress.

• Serve as the principal contact for third-party payers and internal clients in the development, negotiation and review of proposed agreements.

• Review contractual performance of both parties to ensure compliance with terms and to identify conflicts or changes requiring resolution at contract renewal

• Develop methodology and review models that consistently and objectively evaluate the financial impact of proposals.

• Update methodologies as contract issues change.

• Prepare responses to Request for Proposals (RFP) as required.

Minimum qualifications for the ideal future caregiver include:  

• Bachelor’s Degree in healthcare, finance, marketing or related field and five years of experience in contract management

• OR High School Diploma / GED or equivalent and 9 years of related experience

• Strong background involving managed care contracting with health systems to include hospital, professional, ancillary services

• Experience with Fee for Service and Value Based negotiations for Commercial, Medicaid, Medicare Advantage and Marketplace plan types

• Understanding of Revenue Cycle and Managed Care Business Operations

• Managed care experience

• Experience across multiple service lines (e.g., heart and vascular, transplant, women’s health)

• Health system–based managed care contracting experience

• Experience with claims payment methodologies and operations

• Hands-on experience negotiating and managing health insurance contracts

• Working knowledge of contemporary healthcare policies, practices, operations and reim