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Contract Implementation Mgr

Location:

  • NH, Manchester

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Description

Title:   Contract Implementation MGR
 

Location: WFH/Remote- Candidate does not need to reside in posted location 
 

Build the Possibilities. Make an extraordinary impact. 
The Contract Implementation MGR Serves as the single point of contact for Provider Contractors, Provider Relations, and Cost of Care staff for Provider Operations. Manages the end to end process related to the development, configuration and loading of provider reimbursement and demographics in order to maintain provider networks and contracting initiatives.
 

How you will make an impact:
•    Serves as the demographics and pricing subject matter expert. 
•    Oversees the timely and accurate configuration of provider contract reimbursement terms in pricing systems and oversees provider demographic data. 
•    Reviews pricing methodology in provider contracts to ensure it is administratively feasible. 
•    Collaborates with the Provider Contractor to create accurate provider facing rate sheets. 
•    Validates rate sheet and supporting documents using knowledge of contract language and reimbursement methodology. 
•    Researches and rectifies issues. 
•    Develops and maintains relationships with Provider Data Management, Provider Pricing, Provider Contractors, Healthcare Analytics, Cost of Care staff and Provider Relations to ensure successful and proficient daily operations. 
•    Educates Provider Contracting and Provider Relations in their roles as it relates to pricing development and provider demographic processes.
 

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 strongly preferred.
•    Coding Certification strongly 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.ElevanceHealth.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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