Contract Compliance Manager

About the position

Conemaugh Physician Group is seeking a full-time Contract Compliance Manager in Johnstown, PA. The Contract Compliance Manager is responsible for development, implementation, supervision, and evaluation of all contracts in coordination with management and HSC legal and Physician Services for Conemaugh Physician Group. Assists in preparing, examining, analyzing, revising contracts and ensures adherence to, and compliance with appropriate regulations. This position manages Conemaugh Physician Group master contract databases and ensures all corporate and facility agreements are tracked and maintained properly. The Manager Contract Compliance will objectively review and evaluate compliance issues/concerns and compliance related functions. This position monitors provides support and guidance on matters relating to contract compliance. Provides reports to the CPG and HSC leadership at a minimum of annually.

Responsibilities

• Adheres to all policies and procedures regarding privacy and security of health information and in handling of all confidential information as it relates to patients, providers, co-workers and other information as deemed necessary.
• Promotes collaboration and partnerships across Conemaugh Physician Group functional areas; analyzes and monitors internal processes.
• Designs and implements procedures for process or program development and enhancement; determines the priorities, goals and objectives of work functions in assigned areas.
• Clearly communicates problems and concerns regarding areas of responsibility to resolve issues as appropriate.
• Manages Conemaugh Physician Group master contract databases and ensures all signed corporate and facility agreements are tracked and maintained and available through MediTract and renewed prior to expiration.
• Prepares, tracks and analyzes every contract; mitigates risk; tracks authorizations and correspondence.
• Prepares contract briefs and revisions summarizing contractual requirements and budgets to Senior Leadership as requested.
• Monitors contracts performance and develops termination notices to all providers in conjunction with human resources and Lifepoint Health Support Center for non-compliance or changing terms.
• Develops and prepares regular reports on contract status to Senior Leadership and disseminates information to the appropriate directors regarding the status of contracts.
• Performs review of time logs requesting payment to ensure compliance with contract and approves.
• Alerts leadership to contract payment disputes and confers with leadership to assist with contractors, departments, administration concerning contract payments and compliance.
• Thoroughly interprets contract provisions, conducting investigations, identifying issues and resolution for all parties.
• Serves as Liaison/Main Point of contact for physician group real estate with Management Company and HSC Real Estate for management of real estate leases (provision of reports as needed).
• Develops, maintains, and revises contract procedures and conducts contract education for leadership teams as advised by LP HSC.
• Coordinates provider contract administration for compliance and conducts audit to ensure contractor is in compliance with legal requirements, owner specifications and government regulations.
• Keeps the Corporate Compliance Committee and Senior Management informed of the operations and progress of compliance efforts and provides support and guidance on matters relating to compliance.
• Ensures required documentation is available and reported to HSC Physician Services, Legal and Compliance.

Requirements

• Bachelor's degree in health care administration, business administration or related field is required.
• Master's degree in health care administration or business administration is preferred.
• Three to five (3-5) years of experience with contract administration, subcontracting and reviewing of contracts in a healthcare setting or law firm managing healthcare contracts is required.
• Knowledge of the laws governing contracts and compliance management experience is required.
• Paralegal experience is a plus.

Nice-to-haves

• Critical thinking skills, decisive judgment and the ability to work with minimal supervision.
• Excellent computer skills working with Microsoft Office Software including Excel and other applications.
• Ability to develop education and present contract/compliance presentations.
• Superior verbal and written communication skills.
• Strong planning and organizational skills.
• Ability to work effectively with all levels of clinical and administrative staff within the hospital.
• Excellent interpersonal skills to deal with a diverse group of internal / external audiences.
• Flexibility and ability to work in a fast-paced environment and perform multiple tasks/projects simultaneously.
• Team building, project management, reporting, stress management, attention to detail, problem solving abilities and strong decision-making skills.
• Ability to ensure confidentiality at all times.

Benefits

• Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
• Competitive Paid Time Off / Extended Illness Bank package for full-time employees
• Employee Assistance Program - mental, physical, and financial wellness assistance
• Tuition Reimbursement/Assistance for qualified applicants
• Professional Development and Growth Opportunities