Regional Contract Administrator

Job Purpose

The Regional Contract Administrator is responsible for supporting payor contracting for designated accounts as assigned by the Director of Contract Administration and under the direction of the Senior Vice President of Revenue Cycle. This role will be instrumental in contract management (obtaining, organizing, and executing standard contractual agreements and renewals with payors nationally and maintaining contract processes in compliance with applicable Centria Healthcare policies and procedures), knowledge management support of the organization (identify and propagate the contractual obligations associated with contracts, provider manuals, state regulations, and federal statutes to business functions within Centria), and coordinate rate negotiations with the Payor Relations Team (identify and pursue competitive rates from our health plan customers).

Success Measures

Success measures include successful negotiation of contracts assigned and completion thru fully executed agreements; assuring renegotiation requests are initiated timely; review and recommendations of agreements favorable to Centria; and timely communication of contractual and regulatory requirements.

Duties and Responsibilities

1. Payor Relations and Support
   • Negotiate contractual language and financial obligations with various payors (Commercial, Medicaid, Government) in assigned region to ensure compliance with corporate standards.
   • Perform initial outreach and contracting efforts for any new payors in a market.
   • Support Single Case Agreement processes as needed.
   • Support address updates for facility locations tied to contracts.
   • Load and validate CareConnect set up for rates and services under payor agreements for assigned region.
   • Load all payor information to Contract Management System.
   • Facilitate the contract review process for all contracts in assigned territories.
2. Rate Negotiations
   • Monitor market rates and understand how Centria is positioned relative to the market and competitors.
   • Maintain relationships with appropriate contracting personnel at Payor organizations.
   • Monitor for rate negotiations to be initiated regularly.
   • Monitor and update public rate change notices for assigned region.
3. Interdepartmental Collaboration and Support (Knowledge Management)
   • In coordination with Payor Relations and Market Research, present overview of new payors and markets to the Operational team. Make information available on an ongoing basis for the organization – easily accessible and informative.
   • Support RCM/Finance in assuring accurate billing and payments from payors.
   • Support compliance and audit teams with specifics of contract and payor requirements.
   • Coordinate with the Credentialing department on specific payor requirements.
   • Coordinate with Finance to develop UCR for each region and conduct rate analysis to ensure all contractual rates are appropriate.
   • Provide reporting on the status of payor agreements to all impacted departments.
   • Assure all changes in contractual requirements, procedure codes, or processes are communicated to any impacted Centria departments.
4. Compliance with Centria’s Code of Conduct, policies and procedures, and Federal and State laws.
5. Responsibility to report violations of Company policies or the Code of Conduct.

Qualifications

Education

Bachelor's degree or equivalent experience, preferred

Work Experience

• Minimum of two (2) to four (4) years of experience in Contract Negotiation and Management in healthcare orrelated fields, preferred
• Legal or paralegal experience
• Experience in research, preferred
• Experience with Medicaid, preferred
• Experience in healthcare contracting and provider/payor relations, preferred

Equipment and Technology Requirements

• Basic computer skills
• Working knowledge of laptop
• Proficiency in Microsoft Suite (Excel)
• Proficiency in G Suite (Gmail, Drive, Docs, Sheets, Google Meet)
• Experience working with a contract or document management database, preferred

Other Competency Requirements

• Ability to follow written instructions
• Ability to use computers and computer/software programs
• Communication skills

Knowledge and Skills

• Results-driven with an aptitude to apply critical thinking skills, problem-solving, analysis, and sound judgment;
• Strong affinity for building rapport with candidates, explain complicated information in an approachable and easily understood manner, effectively handle challenging phone conversations, and represent the Centria brand;
• Strong communications skills, both written and verbal in the English language;
• Proven adaptability with a willingness to work both collaboratively and individually to achieve desired business outcomes;
• Demonstrated strong work ethic with attention to detail, accuracy, and quality;
• Able to organize, prioritize and handle multiple tasks, adhere to established deadlines, and produce work that consistently meets or exceeds team benchmarks;
• Flexible attitude in accepting unique and non-standard requests from time to time;
• Proficiency in PC software, especially spreadsheet programs.

Working Conditions

• Centria's office hours are Monday through Friday from 8:30 AM – 6:00 PM.
• If supporting a region in a different time zone, schedules may be adjusted to facilitate payor communications in
  those regions.

Physical Demands

While performing the duties of this job, physical requirements such as bending, reaching, lifting, pushing, or pulling up to 30 pounds may be required. This role will require sitting most of the day as well as walking and standing periodically. This role may require close visual acuity on computer screens or monitors and the ability to analyze data and figures on a
screen.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, Veteran status, or disability status. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities, or working conditions associated with the position. Centria reserves the right to amend this job description at any time, with or without written notice.