Regional Contract Administrator

About Centria Healthcare:

Founded in 2009 and headquartered in Farmington Hills, Michigan, Centria Healthcare is a leading provider of home-based catastrophic injury and rehabilitation care, private duty nursing, and supportive living services. Centria Healthcare Autism Services is the largest provider of Applied Behavior Analysis (ABA) for children with Autism Spectrum Disorder (ASD) across the state of Michigan, with services in other states.

Job Purpose

The Regional Contract Administrator is responsible for supporting payor contracting for designated accounts as assigned by the Senior Regional Contract Administrator and under the direction of the Chief Strategy and Growth Officer. This role will be instrumental in contract management (obtaining, organizing, and executing standard contractual agreements and renewals with payors nationally and maintaining contract processes in compliance with applicable Centria Healthcare policies and procedures), knowledge management support of the organization (identify and propagate the contractual obligations associated with contracts, provider manuals, state regulations, and federal statutes to business functions within Centria), and rate negotiations (identify and pursue competitive rates from our health plan customers).

Success Measures
Success measures include successful negotiation of contracts assigned and completion thru fully executed agreements; assuring renegotiation requests are initiated timely; review and recommendations of agreements
favorable to Centria; and timely communication of contractual and regulatory requirements.

Duties and Responsibilities
The below reflects the essential functions considered necessary for a Regional Contract Administrator and shall not be construed as a detailed description of all work requirements inherent in the job or assigned by supervisory personnel. This job description is used as a guide only and not inclusive of all responsibilities and job duties.

Essential Duties

1. Payor Relations and Support
   • Negotiate contractual language and financial obligations with various payors (Commercial, Medicaid, Government) in assigned region to ensure compliance with corporate standards.
   • Perform initial outreach and contracting efforts for any new payors in a market.
   • Support Single Case Agreement processes as needed.
   • Support address updates for facility locations tied to contracts.
   • Load and validate CareConnect set up for rates and services under payor agreements for assigned region.
   • Load all payor information to Contract Management System.
   • Facilitate the contract review process for all contracts in assigned territories.
2. Rate Negotiations
   • Monitor market rates and understand how Centria is positioned relative to the market and
     competitors. 
   • Maintain relationships with appropriate contracting personnel at Payor organizations.
   • Monitor for rate negotiations to be initiated regularly.
   • Monitor and update public rate change notices for assigned region.
3. Interdepartmental Collaboration and Support (Knowledge Management)
   • In coordination with Payor Relations and Market Research, present overview of new payors and markets to the Operational team. Make information available on an ongoing basis for the organization easily accessible and informative.
   • Support RCM/Finance in assuring accurate billing and payments from payors.
   • Support compliance and audit teams with specifics of contract and payor requirements.
   • Coordinate with the Credentialing department on specific payor requirements.
   • Coordinate with Finance to develop UCR for each region and conduct rate analysis to ensure all contractual rates are appropriate.
   • Provide reporting on the status of payor agreements to all impacted departments.
   • Assure all changes in contractual requirements, procedure codes, or processes are communicated to any impacted Centria departments.

Qualifications
These guidelines can be used to make a list of qualifications required (or preferred) to perform the job successfully.

Education

• Bachelor's degree or equivalent experience, preferred

Work Experience

• Minimum of two (2) to four (4) years of experience in Contract Negotiation and Management in healthcare or related fields, preferred
• Legal or paralegal experience
• Experience in research, preferred
• Experience with Medicaid, preferred
• Experience in healthcare contracting and provider/payor relations, preferred

Equipment and Technology Requirements

• Basic computer skills
• Working knowledge of laptop
• Proficiency in Microsoft Suite (Excel)
• Proficiency in G Suite (Gmail, Drive, Docs, Sheets, Google Meet)
• Experience working with a contract or document management database, preferred

Other Competency Requirements

An initial assessment of competency will be completed during the interview period and evaluated on an ongoing
basis.

• Ability to follow written instructions
• Ability to use computers and computer/software programs
• Communication skills

Knowledge and Skills

• Results-driven with an aptitude to apply critical thinking skills, problem-solving, analysis, and sound judgment;
• Strong affinity for building rapport with candidates, explain complicated information in an approachable and
  easily understood manner, effectively handle challenging phone conversations, and represent the Centria
  brand;
• Strong communications skills, both written and verbal in the English language;
• Proven adaptability with a willingness to work both collaboratively and individually to achieve desired business
  outcomes;
• Demonstrated strong work ethic with attention to detail, accuracy, and quality;
• Able to organize, prioritize and handle multiple tasks, adhere to established deadlines, and produce work that
  consistently meets or exceeds team benchmarks;
• Flexible attitude in accepting unique and non-standard requests from time to time;
• Proficiency in PC software, especially spreadsheet programs.

Interpersonal Demands

• Frequent interaction with supervisor, senior leaders, and other teams
• Frequent interaction with customers such as health plans and other payors

Decision Making

• Mostly choosing from other options suggested by leaders and/or teammates
• Will collaborate closely with direct leader relative to approval on decisions of significance

Working Conditions

• Centria's office hours are Monday through Friday from 8:30 AM 6:00 PM.
• If supporting a region in a different time zone, schedules may be adjusted to facilitate payor communications
  in those regions.

Physical Demands

While performing the duties of this job, physical requirements such as bending, reaching, lifting, pushing, or pulling
up to 30 pounds may be required. This role will require sitting most of the day as well as walking and standing
periodically. This role may require close visual acuity on computer screens or monitors and the ability to analyze data
and figures on a screen.

We are an equal opportunity employer and value diversity at our company.  We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, Veteran status, or disability status. This job description is not intended to be an exhaustive list of qualifications, skills, efforts, duties, responsibilities, or working conditions associated with the position.  Centria reserves the right to amend this job description at any time, with or without written notice.