Contract Manager (Fl Region)

About Steward Health Care
Nearly a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country’s largest physician-led, tax paying, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Steward is among the nation’s largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for 12.3 million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.
Based in Dallas, Steward currently operates 39 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah.
For more information, visit www.steward.org.

POSITION SUMMARY:

This position is responsible for negotiating reimbursement rates, legal terms, performance programs, and risk arrangements with managed care health plans on behalf of Steward Health Care System, LLC (including Steward hospitals, physicians, and ancillary providers) under the general direction of the Regional VP. Other key responsibilities include assisting with ongoing contract management including contract analysis, database maintenance, and ad hoc projects.

KEY RESPONSIBILITIES:

• Negotiate hospital and physician managed care agreements for the Florida region
• Perform contract analytics and risk analysis to support leadership decisions about managed care contracting
• Design models and perform analysis for the purpose of understanding the historical and future performance of existing contracts; work with Finance and Revenue Integrity team on models and calculations as necessary
• Create and communicate contract finance and risk terms with internal and external leadership including high-level hospital administrators and physician leaders
• Understand, interpret, and summarize provisions and obligations contained in Steward’s managed care contracts
• Redline agreements to support Steward’s overall goals and objectives
• Load payer contracts, rate sheets, fee schedules and other documents into the managed care database
• Coordinate with Revenue Integrity to ensure timely and accurate contract implementation
• Assist in the development of annual budgets and strategic plans
• Prepare regular internal Management Reports as requested, including the Contract Dashboard, Contract Summary Grid and the A/R Tracking Grid
• Maintain constructive, professional relationships with internal and external stakeholders
• Work closely with the Steward hospitals and physician groups to identify system issues (e.g. claims, underpayments, denials) and develop resolutions that can be addressed in the contract negotiations.
• Monitor, interpret, and report on changes in performance, market trends, health care delivery systems and legislative initiatives that impact managed care efforts (e.g. CMS, ACO regulations, Health Reform, etc.).
• Assist the Vice President and Senior Vice President with other projects as requested
• All other duties as assigned

REQUIRED KNOWLEDGE & SKILLS:

• Analytical skills to collect information from diverse sources and summarize the information and data in order to solve problems
• Accuracy and attention to detail is critical
• Strong interpersonal skills and ability to interact positively with a wide range of constituents
• Proven excellent written and verbal communication skills
• Ability to present information to small, and at times, large audiences
• Strong organizational and project management skills to ensure projects are completed timely and accurately
• Ability to work in a fast-paced, evolving organization
• Must be able to maintain confidentiality of information
• Ability to work both independently and within a team environment
• Ability to travel for health plan meetings and internal Managed Care team meetings as needed

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

Steward Health Care is proud to be a minority, physician owned organization. Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

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