What are the responsibilities and job description for the Payer Contracting Manager - Health Plan Strategy position at University of California San Francisco?
Applies advanced system concepts to negotiate and implement large, complex, and / or specialized clinical services contracts with a variety of managed care organizations (MCOs). Reporting to a Director of Payor Strategy in UCSF Health's Department of Health Plan Strategy and Contracting (HPS), the Contracting Manager (CM) is responsible for supporting UCSF Health's managed care contracting and related operational efforts. These include professional and institutional contracts. The role contributes to UCSF's payer contracting strategy development, locally and regionally, and the long-term management of these critical external relationships.
Read the overview of this opportunity to understand what skills, including and relevant soft skills and software package proficiencies, are required.
Under supervision of the Director, the position directly negotiates and manages UCSF Health's managed care agreements with designated payers of various types (e.g., commercial managed care plans, government payers, and referring medical groups in northern California) through the negotiation of contract rates and associated terms for the provision of hospital services. The CM serves as a long-term owner, relationship manager, and operational liaison between these payers and internal UCSF departments who operate under the terms of payer contracts, including Patient Financial Services, Admitting, Care Management, Legal Affairs, School of Medicine administrators, and others.
The CM must continuously evaluate the health care market for contracting opportunities to help the Director and others in HPS develop effective contracting strategies and operational improvements for its facility and physician contracting, including highly specialized hospital payment programs and pricing as well as complex accountable care risk-sharing agreements. The position is responsible for the development and ongoing management of operational tools to assist various UCSF Health teams in their day-to-day operations and in the resolution of operational issues that arise between contracted payers and UCSF Health.
The CM must be self-directed, have excellent independent judgement, be detail-oriented, and a quick-thinking problem solver and negotiator, applying established HPS pricing principles as well as complex UC Regent and HPS language guidelines and other standards to protect the interests of UCSF Health (hospital and physician) in third-party payer negotiations and the associated operations. Exceptional analytical and problem-solving skills are required, as well as in-depth knowledge of the health care market, in order to assess contract financial performance and to craft rate and language terms that meet and exceed UCSF's financial targets and are consistent with UCSF's operations, all in a rapidly evolving healthcare marketplace.
The CM must have excellent interpersonal and relationship management skills, communicating verbally and in writing (on both an ad hoc and ongoing basis) with clients and payers, internal and external to UCSF. The position also serves as an expert on contracting and related operational issues and frequently facilitates the development of innovative solutions to problems that arise in administrating UCSF's contracts.
The salary range for this position is $110,400 - $212,880. The target entry point is $141,900, based on experience. To learn more about the benefits of working at UCSF, including total compensation, please visit : https : / / ucnet.universityofcalifornia.edu / compensation-and-benefits / index.html
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Salary : $141,900
