The Senior Contracts Specialist is responsible for the negotiation, renewals, terminations, implementation, and management of managed care payer agreements between health plans, medical groups, IPAs, and other third-party -payers on behalf of USC Care Medical Group.
Specifically, the Senior Contracts Specialist will be responsible for program and department-specific contracts including, but not limited to, USC Street Medicine, behavioral health, Keck Community Medical Group (KCMG), Keck Community Medical Group Network Provider (KCMG NP), specialty-specific contracting, and may include contracting efforts related to network expansion.
The Senior Specialist will ensure that contracts are negotiated according to appropriate market trends. The Senior Contracts Specialist will also assist with USC Care system-wide negotiations, as assigned.
Manages and coordinates with applicable units to respond to requests for due diligence as it relates to managed care contracting for KCMG / USC Care provider expansion efforts and onboarding, as assigned.
The Senior Contracts Specialist will oversee the distribution of managed care contracts throughout the company and ensure appropriate communication.
The Senior Contracts Specialist ensures compliance with contract terms, monitors financial performance, and acts as a liaison to resolve contract-related issues, as applicable.
The position is also responsible for researching the legal regulations and collaborating with the legal team. Must be able to work independently to review language and redline agreements, as needed.
After contracts are executed, the Senior Contracts Specialist will assist in ensuring the proper internal implementation by communicating contract changes and maintaining documentation.
The Senior Contracts Specialist be able to work independently yet collaborate effectively with all team members. The successful candidate must be able to organize and prioritize work independently effectively.
Utilizes effective interpersonal skills to initiate, cultivate, communicate, and maintain cooperative relationships with internal stakeholders and outside contracted entities.
The position will maintain relationships with internal and external stakeholders to resolve contract-related operational issues.
Senior Contracts Specialist will report directly to the Director, Managed Care Contracting.
Essential Duties :
- Draft, negotiate, and execute contracts with managed care payers
- Work with stakeholders to insure compliance with contract language, including but not limited to, local and federal laws, regulations, and policies.
- Maintain the information for the contract management system, including but not limited to, contract templates, contract tracking, and contract reporting.
- Collaborate with internal stakeholders to communicate contract terms.
- Manage the contract renewal process and negotiate new contracts as required.
- Monitor contract performance and take appropriate action to address any issues that may arise.
- Collaborate with legal counsel to ensure contracts are legally compliant, mitigate risks and to resolve any disputes that may arise.
- Continuously evaluate and improve the contracting process to drive cost savings and improve efficiency.
- Oversee the distribution of managed care contracts throughout the company and ensure appropriate communication
- Perform other duties as assigned
Required Qualifications :
- Req High School or equivalent
- Req Bachelor's Degree Business Administrative or related field
- If no bachelor's degree, must have at least High School Diploma and additional 4 years of experience in Managed Care Contracting setting.
- Req 4 years Experience in Managed Care Contracting
- Req Negotiation experience with Managed Care Contracting
- Req Exceptional knowledge of managed care agreements, drafting, and contract execution
- Req Excellent skill in negotiating and exchanging ideas with others and to arrive jointly at decisions, conclusions or solutions
- Req Excellent project management skills and ability to manage multiple projects simultaneously; ability to determine the next steps in a process and execute them independently
- Req Strong verbal and written presentation skills and the ability to provide clear information to business / department leads
- Req Strong interpersonal relationship skills both in one-on-one and group situations; securing buy-in and agreement through collaborative effort
- Req Strong drafting skills and knowledge of contract language and able to review terms related to liability, indemnification, insurance, claims submission, payment, fee schedules, and other related terms
- Req Ability to interact effectively both with internal leaders as well as vendors and suppliers
- Req Experience working with and utilizing Office365, Excel, Word, PowerPoint, Access
Preferred Qualifications :
- Pref Experience in large-scale health systems
- Pref DocuSign experience
Required Licenses / Certifications :
Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date.
Required within LA City only)
The annual base salary range for this position is $68,640.00 - $112,370.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education / training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
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