Contract Administrator – Managed Care Organizations LOOKING FOR Contract Administrator – Managed Care Organizations JOB AT San Diego, CA

Family Health Centers of San Diego is looking for a Contract Administrator to oversee contacts between FHCSD and Managed Care Organizations. Under the supervision and guidance of the Director or Managed Care, this position monitors service deliver to ensure quality and compliance. The MCO Contact Administrator evaluates and monitors multiple service agreements. In addition, this position would analyze activity to produce reports that assist with negotiations, implementation, and quality assurance of all managed care contracts and amendments.

Responsibilities:

• Manage and over see contractual relationships with MCOs
• Review contracts to ensure compliance with FHCSD policies and procedures
• Determines contractual implications surrounding patient care delivery
• Prepares appropriate analyses including reports, crosswalks and financial modeling
• Manage multiple, concurrent service agreements and/or contracts across FHCSD
• Evaluate performance of existing contractual relationships and monitor performance of new contractual relationships
• Identify issues, resolve questions, and correct data as needed to ensure accuracy
• Respond to information requests and verify contractor work product
• Provide assistance in preparing requests for proposals
• Educate appropriate staff to all new or revised contractual requirements
• Regularly produce financial impact and clinical quality outcome reports
• Communicate with various departments
• Requests for information with staff, legal counsel, and outside contractors to coordinate responses to inquiries
• Monitors the health care marketplace and policy landscape for operational and financial impacts
• Ensures timely return of any Health Plan information
• Utilize various source documents to analyze information, resolve issues/demands and provide recommendations to management as needed
• Perform other duties as assigned

Requirements:

• Bachelor’s degree or equivalent combination of education and experience
• Minimum of 3yrs experience in a compliance, quality assurance, or contract management-related position
• Must have experience in healthcare, medical or insurance provider industry

Rewards:

• Job type: Regular Full Time
• Competitive Salary: $90,000-$110,000
• Retirement Plan with Generous Employer Match
• Paid Time Off, Extended Sick Leave and Paid Holidays
• Medical/Dental/Vision/FSA/Life Insurance
• Student Loan Repayment and Home Purchasing Assistance
• Employee Discounts, Wellness Programs and Other Benefits

Healthcare plans for families range from $47-$310 no matter how many dependents are on the plan. In addition, FHCSD’s status as a Federally Qualified Health Center provides all of our employees access to extensive and wide reaching programs. For more details and information about all benefits for FHCSD employees please follow the below link.

https://fhcsd.gobenefits.net/benefits-home/resources/your-costs/

More About Family Health Center:

FHCSD was founded by community activists working towards a common goal: caring, affordable, high-quality medical care for all. We are proud to continue this mission today as the nation’s 8th largest Federally Qualified Health Center. We operate 57 sites across San Diego County, including 23 primary care clinics, 16 behavioral health facilities, eight dental clinics, an outpatient substance use treatment program, three vision clinics, physical therapy departments, two mobile counseling centers, three mobile medical units and a pharmacy to support services throughout San Diego County.

Job Type: Full-time

Pay: $90,000.00 – $110,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Referral program
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• compliance, quality assurance, or contract management: 3 years (Preferred)
• Healthcare administration: 1 year (Required)
• Contractor management: 1 year (Preferred)

Work Location: One location