What are the responsibilities and job description for the CONTRACT MANAGER - NC MEDICAID position at Idaho State Job Bank?
Contract Manager - NC Medicaid at Prime Therapeutics in Boise, Idaho, United States Job Description Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. Job Posting Title Contract Manager - NC Medicaid Job Description Summary Responsible for the implementation and support of all activities related to developing and maintaining service provider contracts. Interacts with all areas of the Prime Therapeutics organization to coordinate network management and network administration responsibilities and facilitates resolution of contract issues, obtains legal review and approval of working changes in contract documents. This position is responsible for monitoring provider contract compliance and for development of performance-based contract incentives. Job Description Serves as the point-person for all Contract management, Vendor performance management, and escalations. Provides MES Vendor Performance and SLA support to DHHS as defined throughout this book of business. Negotiates contracts and amendments with Public Network Operators (PNOs), Qualified Service Providers (QSPs), facilities, organizational and / or large group providers, as well as independent practitioners. Works with other departments as needed for timely completion of annual amendment cycles from beginning to end. Manages annual re-contracting efforts across departments. Provides oversight to the Prospective Provider and SCA processes. Manages the Primary Care Management Module (PCMM) and Rates Governance process to address provider requests for contract modification. Minimizes situations where retro-active contract modifications are required. When retro-active implementation is necessary, utilizes streamlined approach to obtain approvals, providing thorough communication to approvers regarding the reason for delay. Monitors ongoing provider performance changes in cost and utilization needs. Develops and maintains professional working relationships with providers. Analyzes contract modification requests and coordinates with the Finance Department on financial impact of any rate / funding changes. Develops and implements process for monitoring provider contract compliance and performance based contract incentives. Identifies and implements process improvements to the contract / amendment process as needed. Ensures that contracts are system compatible, loaded correctly, timely and meet legal and business standards. Ens To view full details and how to apply, please login or create a Job Seeker account
