22 days old

Director, Managed Care Contracting

Umpqua Health
Roseburg, OR 97470
  • Job Code
    125955964
Full Time - Regular
Roseburg, OR, US


POSITION PURPOSE

This position will prepare, review, monitor or maintain provider contracts, leases and other contractual agreements; ensure compliance of applicable rules and regulations; research and prepare reports as needed; and serve in an administrative capacity for all contract matters.

ESSENTIAL JOB RESPONSIBILITIES
  • Responsible for CCO VBP contract proposals and reporting.
  • Partner with Quality and Network Operations as needed.
  • Produce proposals for contract rates and value based care (VBC) arrangements, along with reporting framework and benchmarks.
  • Analyze and report CCO VBP performance, partnering with Quality, and coordinating with Finance re: appropriate contract accruals.
  • Manage contracting staff.
  • Collaborate with the Finance and Data Support Departments in identifying contracting and network development strategies.
  • Work with Network Operations and Leadership in designing, developing and negotiating provider contracts, including identifying alternative payment methodologies.
  • Maintain contracts in accordance with appropriate record retention procedures and internal controls.
  • Develop and prepare performance specifications and requests for proposals.
  • Establish schedules and methods to ensure contract compliance, including required timely payments, and document management. Review needs with management for allocation.
  • Participate in the development of policies and procedures. Make recommendations for change and improvements to existing standards and procedures.
  • Provide various agreement information to potential tenants, consultants, contractors, developers, legal counsel and other external entities.
  • Prepare and complete required agreement information, documents, drafts and amendments. Enter information into computer system, prepare correspondence for approval, and validate contract assignments.
  • Manage the interface and related workflows with external legal counsel and external legal specialists.
  • Collaborate with Umpqua Health's Compliance Department on matters pertaining to contract compliance and vendor performance.
  • Prepare analytical and statistical reports on operations and activities, as applicable.
  • Attend and participate in professional group meetings as needed.
  • Lead Network Performance Committee and collaborate with Network Operations Manager.
  • Comply with organization's internal policies and procedures, Code of Conduct, Compliance Plan, along with applicable Federal, State, and local regulations.
  • Other duties as assigned.

QUALIFICATIONS
  • Bachelor's degree with major coursework in business administration or a related field + 2 years of contract development, contract management or related experience.
  • Principles and practices of research, analysis and report preparation. Able to prepare clear and concise reports.
  • Oversight, principles and practices of contract compliance.
  • Strong English usage, spelling, grammar and punctuation.
  • Knowledge of pertinent Federal, State and local laws, codes and regulations.
  • Ability to interpret and explain Oregon Health Authority policies and procedures, experience with Oregon Health Plan preferred.
  • Excellent verbal and written communication skills as well as outstanding problem solving, organizational, and leadership skills.
  • Proven strong project management, multi-tasking and presentation skills.




PI125955964

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Posted: 2020-11-12 Expires: 2020-12-13

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Director, Managed Care Contracting

Umpqua Health
Roseburg, OR 97470

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