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Contract Manager

Company: Kaiser Permanente
Location: Honolulu
Posted on: April 8, 2021

Job Description:

Important Update: In response to the COVID-19 pandemic, Kaiser Permanente is moving to a virtual recruitment process including telephone and video interviews to help ensure the health and safety of our employees, candidates, and communities. Also, some hiring activities may be delayed or suspended in certain geographic areas and job categories. For more information on Kaiser Permanente's response to COVID-19, visit our Resource Center . Description:
Identifies outside service needs and opportunities to complement overall supplier relationships and care delivery. Collaborates with service chiefs and others to develop contracting strategies. Develops and maintains relationships with external care providers and suppliers. Works with individual doctors' offices. Serves as a resource specialist for contracting and negotiation.

Essential Responsibilities:

  • Identifies and/or anticipates outside service needs to complement overall care delivery.--Collaborates with appropriate leadership teams in development of contracting strategies and other objectives.--Negotiates medical care/service and other contracts for health plan membership and hospitals.--Monitors compliance with contract terms and conditions.--Negotiates resolution of disputes.
  • Develops and maintains relationships with internal/external care providers. Maintains provider relations.--Serves as resource specialist in contracting and negotiation.
  • Monitors external healthcare delivery marketplace and internal utilization trends.--Assesses new opportunities for cost savings, alternative delivery models and financial risk sharing.
  • Develops reimbursement methodologies and understands Medicare and Medicaid reimbursement policies and regulations. Develops payment strategies.
  • Performs analysis of contracts for impact assessment and recommends changes as appropriate.
  • Ensures compliance with related regulatory requirements. Provides counsel to regional leadership and work teams on contracting issues.--Provides direction in communicating contract reimbursement terms to the claims department. Provides direction regarding contract implementation.
    Basic Qualifications:
    Experience
  • Minimum four (4) years contracting experience to include medical expense and utilization analysis or JD with one (1) year of contracting experience.
    Education
  • Bachelor's degree in business, finance, healthcare administration, or related field OR four (4) years directly related experience.
    License, Certification, Registration
  • Valid state of Hawaii Driver's License.

    Additional Requirements:
  • Demonstrated knowledge of healthcare/ commercial/business contracting, financial and policy analysis, healthcare delivery and payment systems, and competitive market strategies systems.
  • Demonstrated knowledge of Center for Medicaid -Medicaid Services payment methodologies and regulations.
  • Demonstrated knowledge of NCQA and TJC accreditation and state and federal regulatory requirements specific to healthcare organizations.
  • Demonstrated knowledge of and skill in adaptability, change management, conflict resolution, customer service, decision making, influence, negotiation, interpersonal relations, oral communication, prioritization, problem solving, quality management, systems thinking, teamwork, time management, leadership, facilitation, and project management.
  • Demonstrated knowledge of and skill in word processing, multimedia presentations, spreadsheet, and database PC applications.

    Preferred Qualifications:

  • Contract negotiations experience.
  • Master's degree in business, finance, healthcare administration, or related field or JD.
  • Demonstrated knowledge of HMO healthcare delivery systems.
  • Demonstrated knowledge of Kaiser Permanente systems and processes. Primary Location: Hawaii,Honolulu,Regional Admin Low Rise Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-HI-01-NUE-Non Union Employee Job Level: Individual Contributor Job Category: Sales and Marketing Department: Regional Administrative Office - Rgnl-Finance Leader - 1208 Travel: Yes, 15 % 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.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
    Connect with a member of the Kaiser Permanente team at an upcoming career or professional event. We look forward to seeing you! Sign up to receive information about opportunities that relate to your interests.

Keywords: Kaiser Permanente, Honolulu , Contract Manager, Executive , Honolulu, Hawaii

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