What are the responsibilities and job description for the Contract Operations Manager for LHCSA and CHHA position at Personal Touch Home Care?

Personal Touch Home Care -

Contract Operations Manager for LHCSA and CHHA

Payor Contract Operations and Credentialing Manager for LHCSA and CHHA

New Hyde Park, NY

About Us : With 50 years of dedicated service to our communities, Personal Touch has been a trusted provider of home care. Our priority lies in ensuring exemplary patient care while fostering a supportive and empowering workplace culture for all team members.

Why Choose Us : At Personal-Touch Home Care, we are committed to creating a rewarding and fulfilling experience for our team members. Our established history and reputation provide a stable and trusted foundation for your career. Join us in positively impacting the lives of our patients and their families. As a member of our team, you will enjoy a wide range of benefits that enhance your overall well-being and support your career growth. They include :

Employee Recognition Programs : We acknowledge and celebrate your contributions.
Comprehensive Health Benefits : We offer an inclusive package with Medical, Dental, Vision, Accident, and Long-Term Disability Coverage to ensure access to quality medical care while promoting overall wellness.
Generous Paid Time Off : We provide generous paid time off to ensure you can recharge and return to work refreshed, leading to greater productivity and job satisfaction. We support a healthy work-life balance.
Retirement Benefits : We offer a 401k plan to secure your financial future and help you save for retirement.
Life Insurance : We offer company paid life insurance providing peace of mind and financial protection for you and your loved ones.
Mileage Reimbursement : We make sure you're compensated for your business travel.
Opportunities for Professional Growth and Development : Empowering you to thrive and grow.
Employee Assistance Program : Supporting the well-being of you and your family.
Perks Program : Exclusive deals and offers on products, services, and experiences you need and love.

Job Summary : The Payor Contract Operations and Credentialing Manager for Licensed Home Care Services Agencies (LHCSA) and Certified Home Health Agencies (CHHA) will play a crucial role in managing and overseeing the administrative and operational aspects related to payor contract management and credentialing. In addition to technical expertise, we are looking for a person who excels in building relationships and fostering a positive, collaborative work environment. The ideal candidate should be a "people person" who is approachable, friendly, respectful, and kind. We value individuals who can communicate effectively with both staff and clients, ensuring a supportive and compassionate atmosphere in all aspects of the role. This role will be reporting to Vice President of Contract and Payor Relations with multi-state oversight.

Job responsibilities

Payor Contract Management :

Monitoring Contract Compliance : Ensure that all terms of payor contracts are being adhered to by both the agency and the external parties involved.

Renewals and Amendments : Track the expiration dates of payor contracts and initiate the renewal process. Implement necessary amendments when changes to services or terms are needed.

Documentation : Maintain all documentation related to payor contracts and ensure it is properly organized, stored, and updated.

Credentialing :

Provider Credentialing : Manage the credentialing process for healthcare providers, ensuring all staff are compliant with regulatory standards. This includes verifying credentials, certifications, licenses, and other required documents.

Ongoing Verification : Conduct periodic audits and checks to ensure continuous compliance with credentialing standards.

Regulatory Updates : Stay current with changes to regulations related to home care services and ensure the organization remains compliant with multiple State specific Departments of Health (DOH) and other relevant agencies.

Insurance Reimbursement : Work closely with billing departments to ensure that the agency is receiving proper reimbursement from insurance companies based on contractual agreements.

Dispute Resolution : Address any provider issues or disputes related to contracts and credentialing processes.

Cross-Department Collaboration : Work closely with clinical, operations, legal, and finance teams to ensure smooth contract execution and compliance.

Reporting : Prepare regular reports for senior management regarding contract status, credentialing updates, and any compliance issues.

Qualifications :

Bachelor's degree in healthcare administration, business administration, or a related field, or a combination of education and experience.

3-5 of experience in healthcare contract management, credentialing, or a related field within the home care or healthcare sector. Management experience a plus.

Certification in healthcare compliance (e.g., CHC - Certified in Healthcare Compliance), contract management, or other relevant certifications may be preferred.

Experience in Home Care :

In-depth understanding of the LHCSA and CHHA environments, including federal and state regulations governing these services (such as New York State Department of Health regulations) and other states regulations

Experience working with insurance companies, healthcare providers, and government entities.

Proven ability to manage complex credentialing processes for healthcare providers, ensuring adherence to required standards.

Familiarity with systems and software used in credentialing, such as those used by healthcare agencies and insurance companies.

Demonstrated knowledge or experience in billing and reimbursement methodologies of healthcare contracts, including terms of service, rates, payment structures, and compliance with legal standards.

Strong attention to detail in reviewing contract terms and ensuring all necessary conditions are met.

Knowledge of state and federal healthcare regulations, including those related to home care, patient privacy, and insurance requirements (e.g., HIPAA, Medicaid / Medicare, and other payer systems).

Experience ensuring compliance with home care-specific certifications and licenses.

Strong interpersonal skills to work effectively with clients, providers, regulatory bodies, and internal teams.

Excellent written and verbal communication skills to prepare reports, contract documents, and compliance updates.

Familiarity with home care management software, electronic health records (EHR) systems, and credentialing platforms.

Proficient in Microsoft Office Suite (Excel, Word, PowerPoint) and contract management systems.

Job Type : Full-time

Pay : $70,000.00-$80,000.00 annually

We are excited to welcome passionate and dedicated individuals to join our team at Personal Touch Home Care. We’re more than just a company, we’re a close-knit family dedicated to supporting each other’s success and well-being. Apply now and join us in making a positive impact on the communities we serve.

Salary : $70,000 - $80,000

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