Job Description

Job Title: Contract Manager

Target Compensation Range: $85,000 - $100,000/year, depending on the level of relevant qualifications and experience.

About Us:

Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members.

Summary: The Contract Manager is responsible for assisting the Contracting Department in developing and implementing a proprietary network and executing contracting efforts with IPAs/Medical Groups, post-acute care, providers and ancillary providers (Network Providers) in support of Astiva Health, Inc.'s expanding business model and to meet the needs of our members. The Contract Manager is responsible for developing and maintaining market relationships with key Astiva Health, Inc. partners. Additionally, the position assists in developing internal market reporting, negotiating Network Provider contracts, and producing client-facing material. This is a collaborative role requiring critical thinking skills, independence, a strategic mindset, and attention to detail.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

• Drafting, amending, revising a variety of contracts.
• Understand and articulate various reimbursement methodologies to current and prospective provider partners.
• Develop the provider network, recruitment, service requests, new IPA/Medical Group, provider, hospital, and ancillary orientations to ensure Astiva Health meets regulatory requirements for network adequacy.
• Coordinate activities with Network Providers to improve satisfaction and manage relationships between Astiva Health and Network Providers in the assigned service area.
• Ensure contract compliance of and access to provider network for all new and existing programs.
• Monitor identified access barriers, billing and reimbursement trends and utilization for provider retention or recruitment process.
• Support Contracting and collaborate with Leadership team on recruitment, issue resolution, reimbursement trends, and assigned projects.
• Make recommendations to department leadership for improvement of any and all procedures and systems at Astiva Health.
• Regular and consistent attendance
• Other duties as assigned

EDUCATION and/or EXPERIENCE :

• Bachelor's degree from an accredited college or university with a focus on Business Administration, Healthcare Administration or Finance or equivalent combination of education and experience.
• 5 years of previous experience in a Contracting role within a Health Plan, IPA/Medical Group or Management Services Organization.
• Strong financial acumen with proficiency in analyzing and interpreting financial trends in provider contracting.
• Detailed contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies.
• Excellent written and verbal communication skills with experience presenting to various audiences.
• Desire to contribute to an organization with constant focus on improving consumer experiences.
• Able to manage multiple priorities in a fast-paced environment.
• Strong working knowledge of MS Office applications, particularly Word and Excel.

BENEFITS:

• 401(k)
• Dental Insurance
• Health Insurance
• Life Insurance
• Vision Insurance
• Paid Time Off

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