Contract Specialist
Company: Cancer Treatment Centers of America
Location: Tulsa
Posted on: January 12, 2021
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Job Description:
Contract Specialist
Cancer care is all we do
Hope in healing
Cancer Treatment Centers of America-- (CTCA--) takes a unique and
integrative approach to cancer care. Our patient-centered care
model is founded on a commitment to personalized medicine,
tailoring a combination of treatments to the needs of each
individual patient. At the same time, we support patients' quality
of life by offering therapies designed to help them manage the side
effects of treatment, addressing their physical, spiritual and
emotional needs, so they are better able to stay on their treatment
regimens and get back to life. At the core of our whole-person
approach is what we call the Mother Standard-- of care, so named
because it requires that we treat our patients, and one another,
like we would want our loved ones to be treated. This innovative
approach has earned our hospitals a Best Place to Work distinction
and numerous accreditations. Each of us has a stake in the
successful outcomes of every patient we treat.
Job Description:
Under the direction of the Vice President of Payer Relations and
Contracting, the Contract Specialist is responsible for managing
relationships with payers and will provide overall management of
the regional contract inventory including maintaining a shared
database with key contract terms, providing accurate and thorough
information regarding fee schedules and implementation, products
and product changes and contract measures and metrics, including
those pertaining to quality and efficiency. Additionally, the
Contract Specialist will be responsible for the resolution of
questions or concerns from/to payers as well as for internal
constituents through operations support and management of Single
Case Agreements and submission of facility
credentialing/recredentialing applications.
Job Responsibilities
50%-
* Responsible for communication to CTCA stakeholders of fee
schedule updates, contractual requirements, product changes,
etc.
* Internal point of contact and champion for ongoing questions
* Lead for facility credentialing process
* Contract term and renew management
* Maintenance and coordination of contracting documents and the
contracting database
* Lead contract implementation
* Lead for payer operational meetings and follow-up
* Key point of contact (externally) for assigned contractual
relationships
* Market support for contract development and nurturing
activities
* Outpatient Care Centers; Lead the effort to add non hospital
service locations to existing payer network agreements.
* Work closely with payers to optimize our physician listings on
their online directories.
* Manage SCA tracking and distribution process including
notification to RCM, facility, and PFSA.
20%- Ensure new contract terms (including payment terms) for Payer
agreements are successfully communicated within the organization.
Ensure that contracts are properly reviewed, executed and uploaded
into the contract database and shared folders. Work cross
functionally across key CTCA departments to ensure health plans are
compliant with rate loading and other operational terms in
accordance with contract effective date.
5%- Support contracting initiatives in accordance with CTCA
business requirements, quality incentive programs and budget
requirements
25%- Key facilitator for regular payer market relationship meetings
(interim JOC meetings) to focus on administrative, transactional,
operational, items including policy changes, claim payment/AR
issues, etc. Responsible for engaging leadership in strategic
issues resulting from meetings, discussions.
Skills, Education and Additional Information
* BS/BA in a relevant field required
* A minimum of three (3) years' experience in managed care
contracting, fee schedule implementation and reviewing of
contracts; or an equivalent combination of education and
experience.
* Have strong communication skills with the ability to communicate
clearly both verbally and in writing and be able to articulate
complex ideas.
* Be a self-starter who is accountable and requires minimal
direction and supervision; a person who is open to new ideas; and a
creative and flexible individual who is comfortable working in a
large, complex organization.
* Possess the personal characteristics of professionalism,
credibility, commitment to high standards, innovation,
discriminating judgment and accountability
* Solid understanding of fee schedule development and
implementation; demonstrated understanding of health care
reimbursement methods and strategies.
* Demonstrated ability to operate collaboratively as part of a
team.
* Strong written/verbal communication skills
* Must be a highly self-motivated individual with the ability to
function in a fast-paced environment with limited supervision and
direction.
* Must be able to handle multiple tasks and priorities.
* Must be able to effectively translate between health plans and
provider communities.
* Must be a dedicated team player with the willingness and desire
to learn and grow within the organization
#AF-HJ
We win together
Each CTCA employee is a Stakeholder, driven to make a true
difference and help win the fight against cancer. Each day is a
challenge, but this unique experience comes with rewards that you
may never have thought possible. To ensure each team member brings
his or her best self, we offer exceptional support and immersive
training to encourage your personal and professional growth. If
you're ready to be part of something bigger and work with a
passionate, dynamic group of care professionals, we invite you to
join us.
Visit: Jobs.cancercenter.com to begin your journey.
Keywords: Cancer Treatment Centers of America, Tulsa , Contract Specialist, Other , Tulsa, Oklahoma
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