Contract Manager - Vendor Performance NC Medicaid - Remote

Remote, USA Full-time
About the position Responsibilities • Responsible for Contract/Vendor Performance. • Serves as the point-person for all Contract management, Vendor performance management, and escalations. • Provides MES Vendor Performance and SLA support to DHHS as defined throughout the Contract. • Negotiates contracts and amendments with Public Network Operators (PNOs), Qualified Service Providers (QSPs), 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. • Provides oversight to the Prospective Provider and SCA processes. • Manages the Primary Care Management Module (PCMM) and Rates Governance process to address provider requests for contract modification. • 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 that contracts are system compatible, loaded correctly, timely and meet legal and business standards. • Ensures contracts audits are accurate and on time. • Provides supervision/performance management to team of contract coordinators. • Works in concert with other teams to respond to changing or emerging system initiatives; actively participates in RFP re-bid processes as needed. Requirements • At least 10 years of experience managing large service and contracts. • Related professional experience in the managed care, healthcare, or insurance industries. • Analytical/problem solving skills. • Excellent verbal and written communication skills. • Strong PC background and efficient in using standard software. • Knowledge of system process analysis and/or program management, estimating IT system development, and testing. • Experience working in Medicare Operations (for positions supporting Medicare). Nice-to-haves • A combination of education and work experience may be considered. • Bachelor's degree preferred. Benefits • Health insurance coverage • Dental insurance coverage • 401k retirement savings plan • Flexible scheduling options • Paid holidays and vacation time • Professional development opportunities • Employee discount programs • Wellness programs Apply tot his job
Apply Now

Similar Jobs

Clinical Contracts Manager, remote | 1036287

Remote, USA Full-time

Contract Manager V

Remote, USA Full-time

Contracts Specialist (Remote US Midwest/West Coast)

Remote, USA Full-time

Contracts Manager, Channel Partnerships & Verticals

Remote, USA Full-time

Contract Administrator / Principal Contract Administrator (Hybrid) - Level 2 / Level 3

Remote, USA Full-time

APD Manager/Contracts Liaison

Remote, USA Full-time

LOTTERY - Purchasing & Contracts Manager (Contract Administration Manager II)

Remote, USA Full-time

Manager, Service Contract and Billable Service

Remote, USA Full-time

Contract Manager - 9

Remote, USA Full-time

Contract Administration Manager

Remote, USA Full-time

Experienced Online Community Support Specialist – Remote Chat Support Role for Content Creators at arenaflex

Remote, USA Full-time

Experienced Data Entry Specialist for Logistics and Courier Services – Entry-Level Opportunity with Comprehensive Training and Career Growth Prospects at arenaflex

Remote, USA Full-time

Coordinator, Accounting & Operations

Remote, USA Full-time

**Experienced Customer Service Representative – Work from Home Opportunity with arenaflex**

Remote, USA Full-time

**Experienced Seasonal Customer Care Specialist – Home Decor and Gift Support**

Remote, USA Full-time

Vertical Sales Engineer I, Spectrum Business

Remote, USA Full-time

[Remote] Work from Home Inbound Customer Service (State of Alabama)

Remote, USA Full-time

Senior Full Stack Engineer for Innovative Healthcare Technology - Remote Opportunity

Remote, USA Full-time

Sr Director Analyst, Artificial Intelligence Technologies such as Generative AI/Machine Learning (Remote United States)

Remote, USA Full-time

Remote Part-time Corporate Travel Agent (SABRE) - Flexible Hours, Competitive Pay, and Career Growth Opportunities

Remote, USA Full-time
Back to Home