Contract Development Manager - Managed Care Contracting

Contract Development Manager - Managed Care Contracting UAB Medicine - 3.9 Birmingham, AL Job Details Full-time $89,770 - $146,055 a year 1 day ago Benefits Paid parental leave Tuition reimbursement Paid time off Parental leave Employee assistance program Loan forgiveness Qualifications Contract management Pricing Medicare Marketing 5 years Bachelor's degree in business Data reporting Mid-level Contract management in healthcare Financial analysis Databases Change management Bachelor's degree in marketing Bachelor's degree Data management Team management Performance Improvement (PI) Prospecting Contracts Participating in conferences Networking through strategic partnership building Request for proposal Negotiated pricing Business Full Job Description Position Overview Pay range: $89,770 - $146,055 / year Benefits and perks available for eligible positions include: robust educational assistance programs, generous paid time off, employee assistance and wellness programs, paid parental leave, qualifying employer for the Public Service Loan Forgiveness (PSLF) Program, plus more. Job Description To align business objectives with employees and management in designated departments. To formulate partnerships across the HR function to deliver value‐added service to management and employees that reflects the business objectives of the organization. To maintain an effective level of business literacy about the business unit's financial position, its midrange plans, its culture and its competitors. To participate in department and organizational process improvement initiatives, change management and special projects. To lead programs and initiatives, champion the organization's culture and develop practical solutions to achieve business objectives. General Responsibilities Contributes to the financial success of UAB Health System by developing and negotiating both Medicare Advantage and Commercial managed care contracts for all UAB Health System provider entities and affiliates. Provides financial, payer contracting and management support to member facilities. Contracts with Medical and other Insurance Payers for immunotherapy procedures, solid organ and bone marrow transplants, general medical, workers compensation, psychiatry, and physician services. Assists the hospitals and providers with payment disputes with payers. Compiles clinical data to promote UAB Health System services. Supervises clerical staff. Manages the contractual relationship between UAB Health System and various Veterans Administration facilities. Key Duties & Responsibilities 1. Develops pricing strategies to maintain UAB's competitiveness in the regional and national marketplace and to generate appropriate margins. 2. Serves as primary contact with prospects (i.e., PPO's, PHO's, HMO's indemnity insurance companies) to initiate quality, high volume direct contracts with various commercial payers for all UAB Health System members and affiliates. 3. Negotiates contractual and reimbursement terms with market payers. 4. Manages existing contracts to ensure negotiated rates are achieved. 5. Serves as the primary contact and negotiates single case agreements with non-contracted payers and with contracted payers for non-contracted and typically highly specialized services offered by UAB Health System. 6. Facilitates approval and signature process for contracts and single case agreements. 7. Negotiates and develops delegated credentialing agreements with contracted payers. 8. Develops, maintains and disseminates monthly provider rosters to contracted payers including quarterly attestation of rosters for all UAB Health System members and affiliates. 9. Resolves provider enrollment issues with contracted payers. 10. Completes annual facility credentialing and re-credentialing applications for managed care clients. 11. Develops and negotiates preferred provider service agreements. 12. Initiates UAB's clinical response to prospects' request for proposals and information, requesting and consolidating data from appropriate Hospital and Professional personnel. 13. Accesses internal databases to retrieve, organize and prepare data for all payers to review existing contract performance and to negotiate future contracts. 14. Reports and presents data to UAB Health System members and affiliates on payer performance including contracted payers and non-contracted payers. 15. Establishes, promotes, and maintains relationships throughout UAB Health System including UAB affiliates in support of organizational and divisional objectives. 16. Establishes and maintains relationships with payers and serves as a point of contact for various payers for contractual disputes and denials. 17. Establishes and facilitates monthly joint operations committee meetings with payers and UAB Health System and affiliates to assist with disputes. 18. Fields questions and answers or follows-up to assure appropriate staff responds effectively. 19. Upgrades and amends existing agreements to include services not currently under contract. 20. Stays abreast of product developments and pricing at competitor medical centers. Reports developments in the marketplace to the Vice President. Attends conferences, participates in professional organizations, and/or reads publications to update knowledge of trends and product development in the field. 21. Responds creatively and effectively to special projects assigned by the Vice President of Managed Care Contracting. 22. Assists in the development of departmental goals, executing projects to achieve these goals, and working closely with others within the organization to continuously monitor department performance. 23. Acts in a caring and courteous manner towards all patients, guests, visitors, students and staff. 24. Performs other duties as assigned. Qualifications Qualifications Bachelor's degree in Business, Marketing or a related field and five (5) years of related experience required. Work experience may NOT substitute for education requirement.

Knowledge / Skills

/ Abilities Knowledge of financial analysis protocols Knowledge of billing and collections Negotiation skills Ability to work as part of a team Why Work at UAB Medicine We are UAB Medicine, Alabama's largest and most comprehensive health system, recognized nationally for delivering world-class patient care, pioneering research, and cutting-edge medical education. We proudly serve more than 1.1 million patients each year - from every county in Alabama, all 50 states, and many countries around the world. Our network spans numerous hospitals, emergency departments, more than 67 other sites of care, and a team of over 2,200 physicians. Our key facilities include UAB Hospital - ranked the No. 1 hospital in Alabama by U.S. News & World Report and home to the state's only ACS-verified Level I adult trauma center and Magnet-designated hospital - along with UAB Hospital-Callahan Eye and five UAB St. Vincent's hospitals serving central Alabama. UAB Medicine offers careers across a wide range of practice environments, from our internationally renowned academic medical center and award-winning community hospitals to our primary and specialty care clinics across the state. Whether you're seeking the fast-paced learning environment of a tertiary care setting or the close-knit environment of a community facility, there's a place for you on our team where you can become part of a mission-driven organization committed to delivering life-changing care. With nearly every medical specialty represented and unlimited opportunities for growth, you'll find the right fit for your skills and career goals. We care for you by offering comprehensive, industry-leading benefit packages to support the individual preferences and circumstances of our diverse staff.