Contract Manager
Full Time
Pasadena, CA
$115,500 - $149,380 a year
Posted Just posted
Job description
Job Summary:
Develops contracting strategies and negotiates contracts for the delivery of services provided by non Kaiser Permanente (KP) providers to KP Health Plan members. Includes accountability to develop and maintain competitive provider agreements. Works in collaboration with Region and Service Area leadership to develop and implement market and service line strategies for care provided by local community providers. Manages the contracting process in an environment of varying reliance on non KP providers. Requires alignment of KFH, SCPMG and Region and Area specific needs.
Essential Responsibilities:
- Develops and implements competitive market and service line negotiation strategies, in collaboration w/Regional and Service Area leadership, for delivery of health care services to health plan members outside the KP system Conversely, on occasion is able to negotiate contracts on behalf of Kaiser Permanente where we are the seller of health care services to non health plan members.
- Manages a portfolio of contacts and community provider relationships for outside services which may have a significant financial impact on the organization.
- Represents the organization as a primary business spokesperson with the community health care providers.
- Assumes designated regional responsibility for monitoring compliance w/ contractual terms and conditions.
- Is involved in dispute resolution Analyzes, models and negotiates financial arrangements and business/operational terms and conditions with outside providers that meet aggressive cost management objectives.
- Evaluates contact performance and makes recommendations to Region and Service Area leadership with respect to new cost management opportunities.
- Participates in Region and Service Area sponsored initiatives relating to outside providers, which may including make vs. buy analyses, options and opportunity analysis for new contacting strategies.
- Represents the contracting department on internal task forces and committees.
- Monitors health care market place and internal utilization trends to assess new opportunities for cost savings, alternate delivery models and financial risk sharing.
Basic Qualifications:
Experience
- Basic Qualfications:
- N/A.
Education
- Bachelor Degree or equivalent experience required.
- High School Diploma or General Educatioin Development (GED) required.
License, Certification, Registration
- N/A
Additional Requirements:
Significant experience in health services contacting.- Strong negotiation skills.
- Excellent understanding of the health care industry, provider community, competitive market strategies.
- Previous experience working with various reimbursement methodologies, financial analysis and decision support systems.
- Demonstrated ability to work independently with a variety of internal and external personnel at various levels of responsibility.
- Strong verbal and written communication required.
- Strong project management, leadership and facilitation skills required.
- Strong analytical skills with experience analyzing medical expenses and utilization.
- Consistently demonstrates the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to customers, contracted providers and vendors.
- Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications:
- A minimum of five (5) years healthcare experience.
- Experience/knowledge of Word, Excel and PowerPoint.
- Masters Degree/MPH/MHSA/MBA preferred.
PrimaryLocation : California,Pasadena,Walnut Center - Regional Offices
HoursPerWeek : 40
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri
WorkingHoursStart : 08:00 AM
WorkingHoursEnd : 05:00 PM
Job Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : NUE-SCAL-01|NUE|Non Union Employee
Job Level : Manager with Direct Reports
Job Category : External Medical Services
Department : Regional Offices - Pasadena - Rgnl Mg Admn-Contracting - 0806
Travel : Yes, 10 % of the Time
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
jjbodyshop.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, jjbodyshop.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, jjbodyshop.com is the ideal place to find your next job.