Contract Manager III

We are so glad you are interested in joining Sutter Health!

Organization:

SHSO-Sutter Health System Office-Valley

Position Overview:

Candidate will come on site for meetings, work, etc. Must live within the Sutter Health Northern California footprint.

This position is responsible ensuring successful payer contract implementation across multiple Sutter divisions and develops strong working relationships with all Sutter Health providers, operational teams and support service departments to ensure payer contract compliance. In addition, this position will support leaders with payer negotiations and payer relations by providing functional support for all the operational units and affiliates within Sutter as well as liaison between payers and Sutter related to collaboration activity, disputed claims, and other projects. This position will also support the department related reports or other projects, such as department training materials, payer claims research, and contract compliance.

Job Description:

EDUCATION:

Bachelor's: Equivalentexperiencewillbeacceptedinlieuoftherequireddegreeordiploma.

TYPICAL EXPERIENCE:

• 5 years recent relevant payer contract implementation and operations experience, including applicable regulatory knowledge

SKILLS AND KNOWLEDGE:

• Knowledge of the operational implications of managed care contracts relative to medical groups, ancillary providers, and hospitals for all types of Payer products, commercial and government sponsored.
• Must be able to enlist cooperation and commitment to carrying out initiatives related to contract compliance or operational implementation.
• Must have the ability to maintain a high level of energy as well as the ability to work independently, prioritize multiple objectives and tasks in a rapidly changing environment and deliver quality outcomes.
• Strong knowledge of provider reimbursement terms for all provider types, including value-based contract terms.
• Negotiation and communication skills related to completing and supporting implementation of contract terms with payers and internal operational teams.
• An understanding of all regulatory requirements for contracting and compliance as it relates to Knox-Keene, Department of Managed Health Care, Department of Insurance, Medi-Cal CMS, HIPPA or ERISA.
• Skills with PowerPoint and Word.
• Ability to build consensus through strong interpersonal skills both written and oral with all levels of the organization.
• Strong organizational skills.
• Ability to interpret payer contract provisions and work through complex payer-provider issues, including claims payment research and communicate with patients, providers and payers as necessary.

Job Shift:

Days

Schedule:

Full Time

Days of the Week:

Monday - Friday

Weekend Requirements:

As Needed

Benefits:

Yes

Unions:

No

Position Status:

Exempt

Weekly Hours:

40

Employee Status:

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $48.72 to $73.08 / hour

The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package. ​