Senior Contract Manager
CareSource
full-time
Posted on:
Location Type: Hybrid
Location: Bronx • New York • United States
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Salary
💰 $72,200 - $115,500 per year
Job Level
About the role
- Ensure provider contract terms and rates are propagated through multiple systems
- Ensure synchronization and validation of contract terms into the Contracts, Authorizations, and Claims databases
- Facilitate a seamless implementation process for providers
- Conduct thorough audits of rates within databases to guarantee accuracy
- Coordinate with third-party software vendors to articulate requirements, develop, and test solutions for effective implementation of business processes
- Serve as the primary finance liaison with internal compliance department
- Collaborate with external provider networks for essential data elements and formats
- Verify payment information is correctly captured and integrated
- Maintain clear communication and coordination with external partners
- Work with IT department to obtain, develop and integrate automated files from contracts
- Ensure amendments are accurately reflected in the system
- Perform and oversee regular audits of the claims system to ensure accuracy
- Ensure discrepancies in provider contract rates are promptly identified and corrected
- Review monthly CMS precluded provider list and notify other areas of business
- Collaborate with Claims and Authorizations senior leadership to align strategies and decisions with organization goals and regulatory requirements
- Actively participate in the development and testing phases of software solutions.
Requirements
- Bachelor's degree required
- Equivalent years of relevant work experience may be accepted in lieu of required education
- Three (3) years of healthcare operations or contracting experience required
- Expert proficiency in databases and Excel
- Ability to meet multiple deadlines timely and accurately
- Ability to anticipate, recognize and resolve issues
- Ability to clearly and concisely articulate issues
- High level of attention to detail and accuracy
- Strong critical thinking and reasoning skills
- Ability to work well with multiple disciplines
- Excellent communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders
- Strong analytical thinking and problem solving skills.
Benefits
- Health insurance
- Comprehensive total rewards package
- Bonuses tied to company and individual performance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
database managementExcel proficiencycontract auditingdata validationbusiness process implementationsoftware testingissue resolutiondata integrationcontract synchronizationclaims system oversight
Soft Skills
attention to detailcritical thinkingproblem solvingcommunicationinterpersonal skillscollaborationorganizational skillsdeadline managementanalytical thinkingarticulation of issues
Certifications
Bachelor's degree