Job Description
Job DescriptionDescription:
Guided Care is seeking a full time Contracting Manager to join our dynamic team. The Contracting Manager is responsible for obtaining contracts and rate raises for our clients (skilled nursing facilities) and managing a client's contracts on an ongoing basis.
Responsibilities
Responsible for a minimum of 280 contract negotiations at any given time. Best practice 300+
Follow processes set forth by senior leadership to successfully obtain contracts/rate raises for clients.
Work to negotiate rates or contract denials from the MCOs initial offer/determination ensuring best results for our clients.
Maintains and updates Guided Care database, Contract Status Report, MCO guides, MCO Guide Processes, MCO Reps with accurate and up to date information as becomes available and known.
Review contract status twice weekly and follow up as necessary with insurance, clients or internally with the goal of completing the contracting negotiations and execution timely.
Maintain a full understanding of Guided Care software for managing contracting workflow.
Prepare and conduct quarterly business review meetings with clients as assigned.
Assist the case management team with contracting-related questions and issued that come up during the verifications, authorization, or billing processes.
Assist clients with reimbursement, claims and change of ownership processes as it relates to insurance and contracting.
Requirements:
*5+ years in Managed Care Contracting within the Skilled Nursing industry
• Strong leadership skills
• Independent and self-motivated.
• Innovative and detail-oriented professional with strong research and organizational skills.
• Thrives in a fast-paced, high-pressure environment.
• Strong time management with a proven ability to meet deadlines.
• Solid collaborative skills with team and clients.