***Available for Hybrid Work***

 

Senior Contract Mangers are responsible for the overall relationships with contracted health plans for the entirety of the OHSU Health System, comprised of three hospital and three large multi-specialty medical group practices. Additionally, this position represents the contracting relationship with payers for the OHSU Health network of community-based practitioners. This position responsibilities includes coordination between OHSU Adventist Health Portland and Hillsboro Medical Center leadership in the development and execution of contracting strategies. Coordinates and directs analytical support between all system entities; negotiation of all contract language and terms that result in effective administration and maintenance of active contracts. The Senior Contract Manager has demonstrated ability to independently cultivate and maintain relationships with key payers, review financial analysis for presentation to leadership, recommend financial and developmental strategies, researches and facilitates resolution of complex contract related issues and serves as an “account manager” for all assigned contracted payers for OHSU Health System. Maintains high level of confidentiality due to sensitive nature of rate and language negotiated. 

 

Additionally, has overall accountability for managing relationships with key OHSU Hospital and Clinic staff. Responsible for resolving issues with contracted insurance companies specific to department needs, as well as managing non-payer contract needs for OHSU clinicians who provide their professional and management services outside of OHSU. Works with department administrators to ensure adequate reimbursement, insurance and all OHSU contract language imperatives are met.

 

The Sr. Contract Manager serves as a resources to Contract Manger’s within the department through training and guidance on complex issues. Finally, the Sr. Contract Manager has overall accountability for managing relationships with key OHSU Health system Hospital and Clinic staff as they relate to contracted payers.

• Develop and execute negotiation strategies that directly impact the financial performance of OHSU health system facilities and medical practices. 

• Builds and maintains a positive client relationship with OHSU health system clinical and business departments and outside clinical vendors with a focus on maximizing reimbursement. 

• Lead negotiation and implementation of complex contracts and act as point of contact for assigned accounts. 

• Communicate with internal stakeholders the status of contract negotiations and potential impact on budget throughout negotiation process and obtain feedback as appropriate to ensure the final contract supports OHSU health system operational and strategic goals. 

• Effectively collaborates with the various OHSU health system Clinical Departments, Hospital Financial Services, Patient Billing Services, OHSU Legal, Risk Management and Medical Groups in rate and language development and proposal analysis. 

• Provide recommendations to OHSU health system leadership regarding growth potential, net reimbursement and contract performance issues. 

• Collaborates with contract analytics staff in selection of methods, techniques and analytical approach to complex reimbursement methods and/or rate negotiation strategies. 

• Ability to independently and effectively communicate with high level executives internally and externally. 

• Demonstrated ability in building and maintaining productive relationship with complex contractual payer relationships. 

• Effectively and independently collaborates with various OHSU Health System areas including Patient Billing Services, Hospital Financial Services, Legal Department and Compliance & Government Relations and to resolve complex issues related to payer contracts. 

• Serve as a resource and provides guidance to Contract Managers within the department.

Education:

• Bachelor's degree in healthcare administration, business, finance, or a related field. Four additional years of contract negotiation or provider/payer relationship management may be substituted for the degree requirements.

Experience:

• 2-4 years’ experience in the healthcare industry in provider/payer contracting, provider/payer relations, or provider/payer analytical capacity.

Job Related Knowledge, Skills and Abilities:

• Understanding of managed care and accountable health system models and relationship to contracting strategy and reimbursement methodology.
• Proven ability to build positive relationships and negotiate successfully with mid-sized and large payers. 
• Demonstrated competency related to varying payment methodologies and value base contracting. (such as Pay for Quality/Performance, DRG, APC (Ambulatory Payment Classifications), ASC, Capitation, Fee for Service, RBRVS, Per Diem, Per Case)
• Ability to analyze financial, quality, and utilization data to develop effective contracting strategies.
• Understanding of pay-for-performance or other value-based payment methodologies.
• Ability to organize and manage a portfolio of contracts with minimal supervision.
• Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity.
• Ability to manage and resolve contract administration issues between OHSU Health and contracted payers.
• Proficiency building relationships and negotiating successfully with payers.
• Ability to communicate with internal/external high-level executives independently and effectively.
• Understanding of clinical and/or hospital operations including patient billing.

Education:

• Bachelor’s Degree in healthcare, business or a related field

Experience:

• 5+ years’ experience negotiating and managing payer/provider contractual relationships.

Job Related Knowledge, Skills and Abilities:

• Negotiation experience 
• Understanding of hospital and/or physician and/or ancillary service reimbursement methodologies
• Contract language Experience
• Project Management
• Ability to understand financial performance reporting
• Attention to detail, organized
• Ability to manage internal stakeholders

General office hours, Monday-Friday 8:00am-5:00pm with some flexibility. Potential travel time, 10-20% as needed for committee and payor meetings. Can be a combination of in-person and virtual (hybrid).

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.