Contracting Manager - Washington, DC, US
9 hours ago
Job description
AHCA/NCAL is seeking a Contracting Manager to improve lives by delivering solutions for quality care by supporting high-quality care through supporting the contracting efforts of AHCA/NCAL Solutions networks. The position supports payer negotiations, assists with the development of Alternative Payment Models, and manages contract education and support for assigned Networks.
Qualifications & Skills:
- Bachelor's degree required; graduate degree in a related field preferred.
- Minimum 5 years of healthcare experience required, including knowledge of post-acute care.
- Proven experience in network development, payer contracting, and negotiation required.
- Value-based reimbursement experience strongly preferred.
- Project management experience required, with ability to prioritize, plan, and execute multiple initiatives effectively.
Duties & Responsibilities:
- Support contract negotiation activities with payers, including messenger model coordination, contract implementation tasks, and ongoing contract administration under the direction of the Senior Director of Network Management and Senior Director of National Contracting.
- Support the development of Alternative Payment Models, including both downside risk (e.g. episodic payment models) and upside only (e.g. incentive payments) models.
- Promote Network participation in population health management models, such as ACO and ISNP.
- Identify new and innovative opportunities to drive value for Network members.
- Assist in preparing materials and analyses to support health plan agreements aligned with AHCA/NCAL standards and industry best practices.
- Assist with the development, documentation, and implementation of innovative contracting models—such as value-based contracts, episodic payment models, and case rates—under the guidance of the Senior Director of National Contracting.
- Collaborate with the Senior Director of Network Management by supporting key account management activities, preparing payer scorecards, and coordinating regular reviews.
- Support members in maximizing contract outcomes by developing contract education and resources and conducting individual contract reviews.
- Assist in identifying, tracking, and escalating contract- and payment-related issues within network agreements to appropriate leadership.
- Perform additional duties as assigned.
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