Contract Manager III, Managed Care

Contract Manager III, Managed Care Sutter Health - 3.8 Sacramento, CA Job Details Full-time $104,332.80 - $156,499.20 a year 12 hours ago Qualifications Research Full Job Description We are so glad you are interested in joining Sutter Health!

Organization:

SHSO-Sutter Health System Office-Valley Position Overview:

This position includes responsibility for negotiating affiliate-specific Letters of Agreements for reimbursement rates with non-contracted payers for commercial and government-sponsored products as assigned for Sutter hospitals, professional and ancillary providers, as well as patient specific Letters of Agreements for reimbursement from self-pay patients under the direction of leaders. In addition, this position will support leaders with payer negotiations and payer relations by providing functional support for all the operational units and affiliates within Sutter as well as liaison between payers and Sutter related to collaboration activity, disputed claims, and other projects. This position will also support the department related reports or other projects, such as department training materials, payer claims research, and contract compliance.

Job Description :

EDUCATION

: Equivalent experience will be accepted in lieu of the required degree or diploma. Bachelor's

TYPICAL EXPERIENCE

5 years recent relevant experience

SKILLS AND KNOWLEDGE

Strong knowledge of provider reimbursement terms for all provider types, including value based contract terms. Negotiation and communication skills related to completing and supporting implementation of contract terms with payers and internal operational teams. An understanding of all regulatory requirements for contracting and compliance as it relates to Knox-Keene, Department of Managed Health Care, Department of Insurance, Medi-Cal CMS, HIPPA or ERISA. Skills with PowerPoint and Word. Ability to build consensus through strong interpersonal skills both written and oral with all levels of the organization. Strong organizational skills. Must be able to enlist cooperation and commitment to carrying out initiatives related to payer contract compliance or operational implementation through education and training. Ability to interpret payer contract provisions and work through complex payer-provider issues, including claims payment research and communicate with patients, providers and payers as necessary.

Job Shift:

Days Schedule:

Full Time Days of the

Week:

Monday -

Friday Weekend Requirements:

As Needed Benefits:

Yes Unions:

No Position Status:

Exempt Weekly Hours:

40

Employee Status:

Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $104,332.80 to $156,499.20 / annual salary The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate's experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health's comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.