At WelbeHealth, we make the impossible, possible for underserved seniors. We do this through utilizing and developing cutting-edge healthcare and well-being service products especially for seniors and their families. Now is your chance to join our talented team that delivers unparalleled creative healthcare, insurance, social support and more to seniors. We create senior well-being through our courage to love, pioneering spirit and shared intention. These values permeate everything we do. At WelbeHealth, you’ll help inspire that magic by enabling our teams to push the limits of healthcare and well-being experiences and create the never-before-seen!
Reporting to the VP, Health Plan Services, the Contracts Manager is responsible for identifying and negotiating contracts with a broad array of service types in geographically diverse areas for both existing and developing provider networks. This person will oversee administration of contracts through management of the Contracts Administrator role and accountability for documentation, software, management of contracts data and provider documentation. This Contracts Manager is a member of the WelbeHealth management team and facilitates collaborative relationships across WelbeHealth and with external stakeholders to promote the WelbeHealth values, team culture and mission. The role will work closely with Provider Relations and Health Plan Services team to collaborate around partnership management, claims, and other related provider operations.
You’ll be responsible for:
- Prepare contract templates and negotiate optimal rates within Medi-Cal/Medicare and value-based environments, across varying methodologies (specialties, hospitals, ancillaries, skilled nursing facilities, nonstandard providers)
- Regularly assess and meet participant needs for provider contracts across our WelbeHealth locations
- Create contract strategy and execute plan for multi-state expansion, collaborate with legal and regulatory attorneys
- Build and enhance Network optimization plan for existing networks, with focus on cost control initiatives to positively impact Medical Expense Ratio and minimize financial exposure
- Mature adequacy evaluation and process for reporting on regular cadence
- Coordinate post-contract implementation and contracts loading with cross-functional teams
- Conduct utilization analysis and develop recommendations for WelbeHealth markets
- Establish strong relationships with contracted partners and ensure partner satisfaction
- Exhibit prowess in navigating contractual language in a regulated environment
- Communicate with high level of customer service and effectiveness to internal and external parties
- Leverage data to inform renegotiation strategy and internal leadership communications
- Support contracting efforts for strategic partnerships
- Manage direct reports including hiring, training, supervising and mentoring.
- Complete all required documentation in a timely and accurate manner.
- Protect privacy and maintain confidentiality of all company procedures and information about employees, participants and families.
- Follow WelbeHealth policies and procedures and participate in any required Quality Improvement activities, staff training and meetings.
Why you’ll love working at WelbeHealth:
- We're a growing program and, as such, you will have the ability to help shape our processes and have opportunity for professional growth.
- WelbeHealth provides a truly special model that allows practitioners to provide care in in a compassionate and relationship-focused way. You’ll be a part of bringing this exciting program to seniors in the community.
- You’ll have the opportunity to develop creative solutions for participants and to practice “person-centered care,” empowering and helping our participants meet their goals.
- Bachelor’s degree required
- Master’s degree in related field, preferred
- Minimum of five (5) years’ experience in contracting, managed care, healthcare administration with at least three (3) years of direct experience in contracting required
- Experience working with large provider groups, IPA’s, hospitals, complex provider types preferred
- Ability to understand and manage contracting across varying regulatory environments and requirements
- Two (2) years’ supervisory experience with demonstrated ability to mentor and develop team members
- Excellent leadership, organizational and communication skills in settings with seniors, their families and interdisciplinary team members
- Experience leading in a data-driven organization, leveraging reports and data to prioritize and manage people and projects.
- Demonstrated ability to prioritize in a fast-paced environment and execute in highly complex function
- Deep commitment to helping unlock the potential of our most vulnerable seniors.
COVID-19 Vaccination Policy
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all of our employees and proof of vaccination prior to employment is required.
Our Commitment to Diversity, Equity and Inclusion
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.