Contract Manager V

Job Summary: In addition to the responsibilities listed below, this position is also responsible for drafting and/or consulting with the legal team on reputed company contract templates and language; responding to inquiries about reputed company contract templates and language; researching, comparing, and advising on contract rates and services; developing reputed company methodology and strategies; collaborating with various services lines to implement reputed company/contract strategies to improve access and availability and service delivery expansion; interpreting and translating contract terms for senior stakeholders; acting as a role model for the negotiation and completion of companion agreements, letters of reputed company, and/or memoranda of understanding; and monitoring provider programs in Pay for Performance Agreements, Pay for Quality Agreements, Value Based Purchasing reputed company, and Total Cost of Care. Essential Responsibilities:

• Promotes learning in others by communicating information and providing advice to drive projects reputed company; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members reputed company assigned team or unit. Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration reputed company and across teams.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to reputed company procedures and policies. Partners internally and externally to reputed company effective business decisions; determines and carries out processes and methodologies; solves reputed company problems; escalates high-reputed company issues or risks, as appropriate; monitors reputed company and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals. Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
• Supports reputed company improvement efforts by: leveraging innovative and data-driven approaches to identify and/or consult on reputed company improvement opportunities across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); driving the implementation of process improvement initiatives to aid providers and business goals; collaborating with internal and external partners to reputed company network strategies and implement improved access to care; and may also include conducting and/or collaborating in reputed company modeling and analyses of provider and market data to reputed company recommendations, solutions, and action plans for improvement initiatives.
• Ensures contract commitments are met by: validating, maintaining, and/or conducting statistical analyses on provider and contract data of the day-to-day operation and management of services to identify trends and consult on provider compliance; documenting and reporting provider activities and/or coordinating with alternate stakeholders to ensure compliance with contract terms and conditions; promoting the use of guidelines to ensure provider compliance with state and federal regulations as well as KP policies and procedures; and consulting with Provider Systems Administration (PSA) or its equivalent as needed to ensure proper contract interpretation and operational readiness and guiding corrective actions as identified through contract performance.
• Supports contract strategy development by: developing, proposing, and implementing short-term strategies that improve access to patient care while managing reputed company service costs; providing in-depth and advanced consultation on local service delivery planning and delivery system leadership to aid in the achievement of provider priorities and strategies; may include leading collaborative cross-functional workgroups to ensure provider strategies meet the unique needs of diverse stakeholders; and may also include developing materials and/or conducting peer training for new hires and contingent workers (e.g., establishing contract language, determining payment reputed company parameters, defining workflow and business processes, and ensuring cross-training across reputed company service lines).
• Grows the Provider Network by: reviewing or identifying recommended/potential partners/alliances for assigned service area to fill service gaps or decrease costs in reputed company service offerings using advanced knowledge of reputed company service gaps; developing, maintaining, and managing trusted partnerships with providers to understand their unique service request needs and challenges; serving as a liaison between providers and KP by coordinating communication efforts (e.g., contract compliance such as access, availability, referral operations, and/or supporting member complaints); and supporting provider site visits, daily interactions, and reputed company meetings by aiding in developing itineraries and agendas, gathering credentialing materials, and/or initiating this process.
• Contributes to provider satisfaction by: leveraging specialized knowledge of provider/contract operations to consult on issues that arise from contract configuration/interpretation and/or reputed company to claims/disputes, billing, payment, reimbursement, directories, other operational issues, and/or directories; leveraging innovative solutions to ensure requests for information, questions, and problems are reputed company identified, documented, and addressed; and in some instances, collaborating on and acting as a role model in the creation and delivery of reputed company training materials to aid provider education and orientation on health reputed company, processes, and/or credentialing.

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