Contract Manager III

About the position

Candidate will come on site for meetings, work, etc. Must live within the Sutter Health Northern California footprint. This position is responsible ensuring successful payer contract implementation across multiple Sutter divisions and develops strong working relationships with all Sutter Health providers, operational teams and support service departments to ensure payer contract compliance. In addition, this position will support leaders with payer negotiations and payer relations by providing functional support for all the operational units and affiliates within Sutter as well as liaison between payers and Sutter related to collaboration activity, disputed claims, and other projects. This position will also support the department related reports or other projects, such as department training materials, payer claims research, and contract compliance.

Responsibilities

• Ensure successful payer contract implementation across multiple Sutter divisions.
• Develop strong working relationships with Sutter Health providers, operational teams, and support service departments.
• Support leaders with payer negotiations and payer relations.
• Provide functional support for all operational units and affiliates within Sutter.
• Act as a liaison between payers and Sutter related to collaboration activity, disputed claims, and other projects.
• Support department related reports or other projects, such as department training materials and payer claims research.

Requirements

• Bachelor's degree or equivalent experience accepted in lieu of the required degree.
• 5 years recent relevant payer contract implementation and operations experience.
• Knowledge of operational implications of managed care contracts relative to medical groups, ancillary providers, and hospitals.
• Ability to enlist cooperation and commitment to initiatives related to contract compliance or operational implementation.
• Strong knowledge of provider reimbursement terms for all provider types, including value-based contract terms.
• Negotiation and communication skills related to contract terms implementation.
• Understanding of regulatory requirements for contracting and compliance (Knox-Keene, Department of Managed Health Care, Department of Insurance, Medi-Cal CMS, HIPPA, ERISA).
• Skills with PowerPoint and Word.
• Strong organizational skills and ability to interpret payer contract provisions.

Benefits

• Comprehensive benefits package.