Responsible for the implementation and support of all activities related to developing and maintaining service provider contracts. Interacts with all areas of the Magellan organization to coordinate network management and network administration responsibilities and facilitates resolution of contract issues, obtains legal review and approval of working changes in contract documents. This position is responsible for monitoring provider contract compliance and for development of performance based contract incentives and rate negotiations.
Negotiates contracts and amendments with facilities, organizational and/or large group providers, as well as independent practitioners.
Works with other departments as needed for timely completion of annual amendment cycles from beginning to end.
Manages annual re-contracting efforts across departments.
Minimizes situations where retro-active contract modifications are required.
When retro-active implementation is necessary, utilizes streamlined approach to obtain approvals, providing thorough communication to approvers regarding the reason for delay.
Monitors ongoing provider performance changes in cost and utilization needs.
Develops and maintains professional working relationships with providers.
Analyzes contract modification requests and coordinates with the Finance Department on financial impact of any rate/funding changes.
Develops and implements process for monitoring provider contract compliance and performance based contract incentives.
Identifies and implements process improvements to the contract/amendment process as needed.
Ensures contracts audits are accurate and on time.
Develops and maintains professional working relationship with providers.
Works in concert with other teams to respond to changing or emerging system initiatives; actively participates in RFP re-bid processes as needed.
Recruits new providers with all license types.
Works on other network management projects as needed.
Other Job Requirements
Responsibilities
A minimum of 5 years of progressively more responsible health care administration experience in contract administration.Demonstrated advanced experience with financial/contractual analysis and negotiations including risk arrangements.Awareness of and/or experience with trends toward contracting integrated healthcare networks.Critical thinker.Self-motivated and a team player.5 years of direct experience in lieu of degree.
General Job Information
Title
Contracts Manager
Grade
25
Work Experience - Required
Contract Administration and Management, Network
Work Experience - Preferred
Education - Required
Education - Preferred
A Combination of Education and Work Experience May Be Considered., Bachelors
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.
Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .
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