Senior Contract Manager (Managed Care Contracting exp required) - REMOTE

Discover Vanderbilt University Medical Center:  Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

Managed Care Ops

Job Summary:

Provides leadership in securing optimal reimbursement and protecting the interests of the organization in contract negotiations, implementation, and management of managed care payor contracts. This position contributes to strategy implementation and negotiations with multi-market health plans and physicians to increase the value of services provided.
 

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KEY RESPONSIBILITIES

• Responsible for working with the analytics team for financial analysis maintenance, negotiation, renegotiation, and management of all contracts with payors.
• Plans, prioritizes, collaborates and communicates information regarding projects, issues, and negotiations to ensure relationships are maintained.
• Collaborate with Revenue teams to assist with any billing/ claim issues
• Negotiates contracts with payors based on strategic and financial goals, prior contract performance, projected contract performance, and thresholds.
• Analyzes and finalizes contractual language for operational and financial appropriateness.
• Develops and maintains internal education communication processes and other tools to enhance contract performance, identification and compliance.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.
• Collaborate with Revenue teams to assist with any billing/ claim issues and lead joint operational committee meetings

TECHNICAL CAPABILITIES

• Financial Analysis (intermediate): The process of evaluating businesses, projects, budgets, etc. to determine their performance, stability and profitability.
• Contract Negotiations (intermediate): Demonstrates an understanding of negotiating skills such as building trust, gaining commitment, managing the opposition and maintaining goodwill. Realizes the need for mutual concessions and accommodations and negotiates with others for resources, actions or buy-in to maximize collaborative outcomes.
• Networking (Intermediate): Build relationships through industry contacts, professional organizations and individuals.
• Communication (Advanced): Clearly, effectively and respectfully communicates to employees or payors.

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities:

Organizational Impact: Independently delivers on objectives with understanding of how they impact the results of own area/team and other related teams. Problem Solving/ Complexity of work: Utilizes multiple sources of data to analyze and resolve complex problems; may take a new perspective on existing solution. Breadth of Knowledge: Has advanced knowledge within a professional area and basic knowledge across related areas. Team Interaction: Acts as a "go-to" resource for colleagues with less experience; may lead small project teams.

Core Capabilities :

Supporting Colleagues: - Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas. - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships. - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Services: - Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them. - Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions. - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly. - Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure. - Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area. - Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation: - Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches. - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges. - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

Position Qualifications:

Responsibilities:

Certifications:

Work Experience:

Relevant Work Experience

Experience Level:

5 years

Education:

Bachelor's

Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity.  EOE/Vets/Disabled.