- Perform management responsibilities to including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Manage the contract development team and provide process guidance for the development of facility, ancillary, and professional multi-market templates for commercial and Medicare Advantage lines of business covering WPA, CPA, NEPA, statewide PA professional, WV, and DE.
- Serve as the lead in managing contracting life-cycle management (CLM) software; primary liaison to CLM vendor; plan contract integration into the CLM solution; and ensure CLM solution and process meet all regulatory compliance requirements.
- Manage the contract development team and provide process guidance for the development of value-based reimbursement agreements.
- Provide support to the markets in all provider terminations including managing staff in the development of termination notices and serve as the primary contact to applicable regulatory agencies to ensure all reporting obligations and member transition obligations are met.
- Oversee and manage staff in reviewing provider changes including asset sales and mergers.
- Assign and provide guidance to staff in market contract language risk assessments including the interface with legal for joint risk assessments.
- Other duties as assigned.
- Bachelor's Degree in Business Administration/Management, Procurement or Health Administration
- 6 years management experience or 6 years of contract management experience
- Master's degree in Business
- 5 - 7 years in the Healthcare Industry
- 5 - 7 years in Management
- 5 - 7 years in Contract Development
- 1 - 3 years in Legal
- None
- None
- None
- Contract Management
- Business Process
- Operations Management
- Procurement Contracts
- Legal Analysis
-
Client Manager
3 weeks ago
Talos Automation Michigan, United StatesClient Manager · General: · This role is largely to act as the intermediary between the Client and the Business Unit and to ensure a successful business relationship. The responsibilities include managing the entire sales process, closing the deal, and managing the contract with ...
-
Corporate Counsel L2
1 week ago
NTT Michigan, United States Full timeJOB DESCRIPTION NTT is a leading global IT solutions and services organisation that brings together people, data and things to create a better and more sustainable future. · In today's 'iNTTerconnected' world, connections matter more now than ever. By bringing together talented ...
-
Sales Executive BPO
2 weeks ago
Wipro Michigan, United StatesThe Sales Executive is accountable for net new sales for Wipro. Sales Executives should be able to establish strong relationships with the clients (including CxO level relationships) using their industry experience and network , and open doors for the new opportunities in the mar ...
-
MEP Estimator
2 weeks ago
TEC Group, Inc. Michigan, United StatesMy construction client is seeking a talented individual to lead hard bids and negotiated proposals for our manufacturing, power, and energy projects. We are looking for a proven professional with a strong track record in creating competitive bids and budgets, with a comprehensive ...
-
Information Technology Sales Manager
2 weeks ago
Addison Group Michigan, United StatesTitle: Senior Sales Account Executive · Industry Musts: Information Technology Services/Consulting/Custom Software · Location: Detroit Metro Area OR Grand Rapids Area - Local travel to clients - Home office · Salary: $80-110K + commission based on new business and renewals · As a ...
-
Assistant Project Manager
2 weeks ago
Flowtec Group Michigan, United StatesClient Overview: · With over $200M in yearly revenue, my client is looking for an Assistant Project Manager to immediately come on board and help lead construction projects ranging from $10M-50M in a variety of sectors including healthcare, education, commercial, and retail. This ...
-
Construction Inspector M/F
2 weeks ago
Egis Michigan, United States Permanent contractGeneral information · Organisation · Egis is an international player active in the consulting, construction engineering and mobility service sectors. · We design and operate intelligent infrastructure and buildings capable of responding to the climate emergency and helping to ...
-
CAD Designer
2 weeks ago
Tech Providers, Inc Michigan, United StatesJob Title: Design Technician II · Duration of assignment: 12 months contract that will very likely extend and be ongoing · Location: Multiple Michigan locations let you work conveniently from an office near you. Hybrid role for flexibility. · Duties: · The GAM M&R EI&C designer i ...
-
Oracle Project Manager
1 day ago
Softworld, a Kelly Company Michigan, United StatesProject Manager (Oracle ERP) · Location: Troy, MI Remote + travel · Duration: 12-month contract + extensions · We are currently seeking an experienced Project Manager to fill a crucial role within our clients organization focused on an Oracle ERP Implementation. This individual w ...
-
Enterprise Data Architect
2 weeks ago
Forsyth Barnes Michigan, United StatesTitle: Enterprise Data Architect · Location: Hybrid, Ann Arbor , Michigan (3 days a week, on-site) · Rate: $80-$100 an hour · Contract role – Contract to Hire · Brief Overview: · Forsyth Barnes are very excited to be partnered with a well know fast food supplier who are looking f ...
-
Information Technology Manager
1 week ago
Venteon Michigan, United StatesWe were recently engaged in a search for a Senior IT Manager for a manufacturing company, located in Metro-Detroit. This is an exceptional opportunity for an individual with expertise in managing ERP systems and providing plant-level IT support across multiple locations. · The Se ...
-
Materials Manager
6 days ago
LHH Michigan, United StatesResponsibilities: · Supervise the material management process to guarantee timely delivery of high-quality products. · Identify and engage external suppliers when necessary. · Implement and uphold processes to maintain regulatory compliance. · Analyze current material availabilit ...
-
Senior Buyer, Advanced Programs
1 day ago
DSJ Global Michigan, United StatesThe ideal candidate will be responsible for managing the deliverables for new and series production programs, ensuring timely sourcing & procurement of materials, and maintaining strong relationships with suppliers to align with program targets. · Key Responsibilities: · Program ...
-
Trade Management Executive
1 week ago
Livingston International Michigan, United StatesTrade Management Executive · Join Livingston, the largest customs broker in Canada and the third largest entry filer in the U.S. We're a market leader offering customs brokerage, consulting and compliance, and freight forwarding services at more than 90 key locations in North Ame ...
-
Director of Business Development
6 days ago
SFE- Southwest Foodservice Excellence Michigan, United StatesReady to change the world? At SFE, we are fueling students to take on their school day one meal at a time, and we need YOU to help bring those healthy, great tasting meals to their plates every day. With a schedule that follows the school calendar and offers flexible hours, a pos ...
-
Compliance Counsel
1 day ago
Firm Advice Michigan, United StatesFirm Advice has a great opportunity for a Compliance Attorney to join an international, household name conglomerate. You will assist the General Counsel and business partners in implementing and managing the Ethics and Compliance program. The areas in which you will primarily pro ...
-
Sr. Datastage Developer
3 weeks ago
Info Services Michigan, United StatesSr. Datastage Developer only on w2 please do not apply for c2c · Long term contract · Top Skills' Details · 1. Datastage Development · 2. PL/SQL Development · 3. Data Warehousing experience · Secondary Skills - Nice to Haves · Job Description · We are seeking a highly skilled and ...
-
Plant Human Resources Manager
2 days ago
Akkodis Michigan, United StatesLocation: New Boston, MI (Fully On-site) · Pay Range: Up to $140K · Must Haves: Union experience, a lot of leadership experience years), automotive background, production background. · Incentives: $600 car allowance monthly, Manager bonus 10% of yearly salary based off performan ...
-
Construction Project Manager
4 weeks ago
Flowtec Group Michigan, United StatesA Detroit Civil Contractor with a 30 year track record is looking to add a Project Manager to their team. They have a strong backlog for the next 2 years due to an influx of work both in private sectors and with MDOT. The ideal candidate will have 3+ years of project management e ...
-
Business Development Manager
1 week ago
Mankiewicz Coatings USA Michigan, United StatesMankiewicz celebrated its 125th anniversary in 2020. Our long-established company has been producing and selling high-quality industrial coatings since 1895 and is now one of the most successful globally-active coatings companies. From small manufacturers to large global corporat ...
Manager Provider Contract Development - Michigan, United States - Highmark Health
![Highmark Health background](https://contents.bebee.com/companies/us/highmark-health/background-JpcGU.png)
Description
Description
:JOB SUMMARY
This job manages the business process of contract management with internal departments.The incumbent oversees the staff and facilitates the development/editing and interpretation of provider contract language. Accountable for all contracts including multi-market facility and ancillary agreements as well as value based contracts.Works with the Organization's internal legal department to develop recommended contracting strategies and interpret contract language and risk. Provides support to markets regarding any terminations including any required regulatory reporting.
This role is hybrid with 3 days a week onsite if you live within 50 miles of a Highmark office.
ESSENTIAL RESPONSIBILITIES
EDUCATION
Required
Substitutions
Preferred
EXPERIENCE
Required
Any one of the following
Preferred
LICENSES AND CERTIFICATIONS
Required
Preferred
SKILLS
Language (other than English)
None
Travel Required
None
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-Based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Never
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Occasionally
Lifting: 10 to 25 pounds
Rarely
Lifting: 25 to 50 pounds
Rarely
Pay Range Minimum:
$78,900.00Pay Range Maximum:
$146,000.00Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ()
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please contact HR Services Online at