Contract Administrator, Value Based Initiatives
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Job Location:
Saratoga Springs, NY - USA
Monthly Salary:
$ 71612 - 110999
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Department/Unit:
Integrated Delivery SystemsWork Shift:
Day (United States of America)Salary Range:
$71612.39 - $110999.20tThe Contract Administrator System Value Based Initiatives (Contract Administrator SVBI) makes data-supported recommendations supports the development of AMC/IDS AMHS contracting strategies and as assigned negotiations/negotiates with established and new payers both commercial and governmental. Support functions include but are not limited to economic and risk assessments in collaboration with Corporate System Finance and ensuring implementation and operational performance of such contracts consistent with the negotiated terms. The Contract Administrator prepares contract proposals for internal review and consideration prepares for and conducts meetings/negotiations presentations and other organizational functions as assigned. The Contract Administrator maintains strong relationships working collaboratively across AMC/IDSAMHS and payer organizations. This includes but is not limited to coordinating operational input across all applicable internal System departments including Practice and Hospital Administration Billing Finance Information Systems Utilization Management Quality Credentialing Managed Care Organizations payer and other related internal and external entities. For each AMC/IDSAMHS contract portfolio the Contract Administrator assists with the development of reporting instruments including but not limited to contract performance parameters and/or profit/loss comparisons by service. The Contract Administrator works collaboratively within the Department to develop payer profiles to include but not limited to membership market share financials products and volumes at AMC/IDSAMHS.The Contract Administrator System Value Based Initiatives meets with representatives of payers managed care organizations and other agencies to assist in the evaluation of current contracts or development of new contracting opportunities with focus on value based payment to include those under Federal and NYS reform for AMHS. Reviews proposals and makes data informed recommendations for internal consideration in preparation for negotiations.
In conjunction with the Director or at the direction of VP for Payer Contracting negotiates contract parameters and methodologies and prepares/presents proposals representing AMHSs position. Works cross functionally across AMHS to evaluate and develop such proposals identifying opportunities and risks. Presents such opportunities and risks as directed. Collaborates with the Legal Quality and Compliance Department and other departments across AMHS to ensure compliance and implementation capabilities.
Works cross functionally across AMHS to review terms and performance of each established contract portfolio; makes data informed recommendations for methodology changes including but not limited to those related to value based payment identifying opportunities and risks.
Mediates contract disputes to resolution and ensures compliance (both internally and externally) with contract provisions.
Monitors contract renewal dates to ensure appropriate review is conducted. Coordinates with Finance and others to ensure timely/applicable contract analyses. Reviews for risks and works collaboratively with Financial Reporting to ensure appropriate modeling. Understands all modeling parameters and reports on such.
Responsible for contract education to various System-wide departments including executive leadership Finance Billing Quality Clinical Departments and Practice Administration as required. Responds to requests for further information and follow-up as required.
Plans presentations and meetings including preparing narrative overheads and handouts as assigned. Ensures accurate reporting in all prepared presentations for documentation/archiving.
Monitors contract performance by independently collecting data analyzing and completing spreadsheets to include comparative and economic assessments and reports on such. Works collaboratively with Data Analytics to develop routine reporting instruments for AMHS.
Maintains broad knowledge of payers in the AMHS market and beyond whether contracted or not. Assists with gathering of current data on all major managed care organizations including information regarding: financials current membership physician networks and current/future marketing plans. Assists with the development of and prepares/presents reporting instruments for the AMHS.
Maintains the absolute confidentiality of patients and AMHS contracts
Promotes and contributes positively to System-wide intra-departmental and inter-departmental relationships by cooperating with the resolution of conflicts which may develop.
Performs special projects and assignments as requested by the Director or VP for Payer Contracting. Assists with IDS Affiliate contracting processes related to payer contracting.
Knowledge base must remain current in changes regarding Federal and New York State regulations of provision/reimbursement of medical services including but not limited to federal and NYS VBP Roadmaps.
QUALIFICATIONS
Education
Bachelors Degree in Business and/or Health Care Administration
required
Masters Degree in Business and/or Health Care Administration
preferred
Equivalent combination of relevant education and experience may be substituted as appropriate
4-6 years in managed care negotiations and managed care network operations
required and 1-3 year in and able to lead complex payer negotiations and mediation.
Thank you for your interest in Albany Medical Center!
Albany Medical is an equal opportunity employer.
This role may require access to information considered sensitive to Albany Medical Center its patients affiliates and partners including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:
Access to information is based on a need to know and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts consistent with Albany Med Center policies and standards shall be made to ensure that information is adequately protected from unauthorized access and modification.
Required Experience:
Unclear Seniority
Key Skills
About Company
Albany Medical Colllege is one of the oldest medical colleges in the country, associated with one of the largest medical centers in NYS. Visit AMC.edu today!
