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Contract Implementation Manager (Contract Compliance Manager)

Location:

  • MA, Boston

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Description

Title:  Contract Implementation Manager (Contract Compliance Manager) 
 

Location: Hybrid | Boston, MA | Posted state preferred but not required
 

Build the Possibilities. Make an extraordinary impact. 
The Contract Implementation Manager serves as the single point of contact for Providers and Clients. Management. He/she will manage the end to end process related to the development, configuration and loading of provider/client requirements, rates and other demographics and other contractual requirements in order to maintain adequate network requirement. 
 

How you will make an impact:
•    Oversight of the implementation of all EOHHS- contractual requirements, inclusive of contract amendments approved plans, policies and timelines; 
•    Serve as the primary liaison with the client for ongoing contract management related issues. 
•    Develops and maintains relationships with internal operations inclusive of Data Management, Pricing, Contractors, Healthcare Analytics, Cost of Care staff and Provider Relations to ensure successful and proficient daily operations to meet contract requirements. 
•    Ensure timely and accurate configuration of contract amendments and provider rates and  reimbursement requirements 
•    Serves as the plan coverage, demographics and pricing subject matter expert. 
•    Reviews pricing and rate methodology requirements  to ensure  administrative  feasibility. 
•    Manage the tracking system for management of all client contract compliance related issues related issues  
•    Works to promptly resolve any contract-related issues identified by the Contractor or EOHHS, tracks compliance of all Contract requirements and deliverables and maintains records of all compliance activities.

Minimum Requirements:
•    Requires a BA/BS degree in a health related field and minimum of 5 years’ experience in the health care industry with background in provider relations, facility contracts and reimbursement; or any combination of education and experience, which would provide an equivalent background.
 

Preferred skills, capabilities and experiences: 
•    MBA, MHA or related graduate degree and Coding Certification strongly preferred.
•    Client management with government contracts (Medicaid) preferred. 
•    Project Management experience preferred.
•    Microsoft Suite, proficiency with Excel and PowerPoint, experience preferred. 
 


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

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