Sr. Contracts Manager

Job Description

Job Description

About Our Company

At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. At Altais, we’re building breakthrough clinical support tools, technology, and services to let doctors do what they do best : care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include : Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.

About Your Team

Are you looking to work with a high performing, fast growing and dynamic Inpatient Contracting team? We are 4,000 physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.

About Your Work

Responsible for managing and negotiating Payer Contracts for all lines of business; Commercial, Medicare and Medi-Caid HMO, PPO, and ACO. Primary duties include health plan operations, contract analyses, negotiations and contributing to operational implementation.

You will focus on :

• Works to achieve operational targets with major impact on the departmental results. Contributes to the development of goals for the department and planning efforts (ie modeling and negotiation of rate increases, execution of expansion Statewide strategies, claims integration implementation, etc. ).
• Influences the performance of the business unit or related functional areas in achieving company objectives.
• May manage large projects or processes that span outside of immediate job area (ie health plan contract implementations). Work is performed with limited oversight.
• Typically, responsible for providing guidance, coaching and training to other employees within job area.
• Typically, responsible for managing major / complex projects involving delegation of work and review of work products.
• Viewed as a specialist within discipline.
• Responsible for making moderate to significant improvements of processes, systems or products to enhance performance of job area. Issues faced are numerous and undefined, and require detailed information gathering, analysis and investigation to understand the problem.
• Effectively conducts negotiations with health plan and payer partners to achieve operational efficiency and budgeted results on a timely basis with moderate supervision :
• Conducts review of historical / potential financial performance of the contracts, using MLR financial reports and previous negotiation history.
• Prepares negotiation letters and sends them out in a timely manner to begin negotiations.
• Tracks negotiation history and creates rate comparison grids and other resources to show negotiation progress.
• Researches the effect of contract and financial terms with operating departments.
• Work with other departments to ensure operational concerns are addressed in new contracts.
• Ensures contract language abides by state and federal law and community standard. Any deviations from language must be signed off by the appropriate department lead and / or Legal.
• Drafts and implements accurate and timely written communication pieces regarding new and renewed health plan payer arrangements and to the network and appropriate departments, including :
• Tracks all negotiations for Senior Executives and Board of Director Summaries.
• Communicates results of the finalized arrangement for presentation to internal departments as appropriate, i.e. some redacted versions.
• Solicits information and feedback from operating departments regarding, implementation and performance of contracts as required.
• Maintains all health plan payer contract data in a Health Plan Contract Summary grid or contract management database with reportable functionality.
• Develop and maintain successful relationships with Health Plan Payer partners and maintain a contact list of all levels of health play payer partner Contracting staff.
• Act as liaison for resolution of problems related to the operations of all health plan contracts.
• Maintain organization of health plan payer resources on BTNet, i.e. Provider Manuals, Contact List, Communication Notices, DOFR’s, etc.
• Support Provider Contract negotiations, as necessary.
• Conducts organizational in-service / education of organization on health plan payer relationship and contract terms.
• Performs all office functions accurately within reasonable limits based upon established needs and specified deadlines.
• Accepts and performs other related duties and responsibilities as required

The Skills, Experience & Education You Bring

You Share Our Mission & Values :

Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate’s starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate’s qualifications, skills, and experience.

Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our ‘CPRA Privacy Notice for California Employees and Applicants’ to learn how we collect and process your personal information when you apply for a role with us.

Physical Requirements : Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office / deskwork – Activity level : Sedentary, frequency most of workday.

External hires must pass a background check / drug screen. Qualified applicants with arrest records and / or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.