Contracts Manager

Date: Jun 17, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 7283 

 

Position Summary/Position

 

Under the direction of the Director of Provider Contracting and/or the Provider Contracting Manager, the Contracts Manager is responsible for the management and maintenance of the entire provider network (Primary Care Services, Specialty Services and Ancillary Services) including but not limited to negotiation of contract rates and terms, timely renewal of all contracts to ensure continued network participation, initial processing of all credentialing applications for all new providers, communication with providers to address and assist with additional needs including managing all requests for rates increases; Physician recruitment to identify new leads to increase network access and meet network adequacy as per regulatory requirements. Research and follow up on all internal emails sent to the Contracting Department requesting contract/provider information; Supporting the Director of Provider Contracting and Provider Contracting Managers in all required or directed activities.

Major Functions (Duties and Responsibilities)

 

1.   Develop and negotiate Provider agreements.

2.  Recruit and maintain a network of required/requested providers in an assigned geographic region. The network will include: primary care, specialty care, ancillary, hospitals and other health plan providers.

3.   Participate as directed by the Director of Provider Contracting and/or the Manager with Network Development.

4.  Participate in developing various payment methodologies and analyzing rate proposals for providers. Requires the ability to perform and monitor on-going  financial  analysis  of contract performance.

5.   Work with assigned support staff to ensure contract inflow and outflow is being maintained.

6.   Assist in the preparation, coordination and analysis of all Request For Proposals (RFP) for the Department.

7.   Assist the Provider Services Department as needed.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leading: Self

Experience Qualifications

 

Three (3) years of experience in a Managed Care environment, emphasis on Provider contracting. A minimum of two (2) years of direct experience in Provider contracts.

Preferred Experience

 

Experience in negotiating Provider contracts preferred, but not required.

Education Qualifications

 

Bachelor’s degree from an accredited institution required. 

Preferred Education

Professional Certification

Professional Licenses

Drivers License Required

Yes, must have a valid California Driver's License.

Knowledge Requirement

 

Thorough knowledge of contracting structures and payment methodologies preferred.

Skills Requirement

 

Provider contracting and  analytical  skills  with emphasis  on time management, financial analysis, and problem solving. Microcomputer applications (Microsoft Word and Excel required) for use in all aspects of an office environment. Excellent communication, interpersonal and organizational skills.

Abilities Requirement

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

A valid California Drivers License required.

Word processing, spreadsheet and database analysis involving computer keyboard and screens, automobile travel within the Inland Empire.

Work Model Location

Physical Requirements

 

Starting Salary: $61,422.40  - $78,312.00  

Pay rate will commensurate with experience

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 7,000 and a team of more than 2,500 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles