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Posted: Friday, March 17, 2017 11:19 AM

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Company Name: Chinese Community Health Plan

Job Function: Management

Description
Established in 1986, Chinese Community Health Plan (CCHP) is the health plan subsidiary of Chinese Hospital. Our mission is to improve the health of our community by delivering high-quality, affordable healthcare through culturally competent and linguistically appropriate services. CCHP offers coverage to Large Employer Groups, Individuals & Families and Small Employer Groups (on and off the health insurance exchange). CCHP also offers a Medicare Advantage HMO and Dual Eligible Special Needs Plan. If you want to help improve community health in a collaborative team-oriented environment, CCHP is the right place for you. We offer a competitive benefits package and a great place to work.

POSITION SUMMARY
The Provider Contract Manager is responsible for developing, executing and managing CCHP, Chinese Hospital & Clinic provider-payer contracts through a collaborative team approach. The effective candidate overseas the daily activities of the Provider Network Management Department and must demonstrate effective working relationships with Senior Managers and clinical staff from CCHP and Chinese Hospital, providers and customers. Candidate must be able to communicate effectively and persuasively while ensuring compliance with state and federal regulatory requirements. The position provides timely industry insight to aid in the refinement of provider network and delivery system strategies.

ESSENTIAL DUTIES AND RESPONSIBILITIES
• Develop contract proposals and negotiate provider-payer, provider-provider contracts
• Develops strategy and selection of appropriate contract vehicle, financial models and range of terms in partnership with Senior Management, Clinical, Financial Legal and Operational departments.
• Collaborates with above departments to perform financial and utilization analysis in the development and evaluation of rate proposals.
• Facilitates completion, implementation and ongoing monitoring of financial, operational performance standards of contracts
• Keep abreast of industry trends, regulation, legislation, and payment rules and methodologies.
• Establishes and maintains positive relationships and acts as key contact for contract issues with providers and their senior leadership.
• Identifies, creates, revises and implements policies and procedures and workflows to document key department responsibilities and tasks.
• Facilitates and staffs the Provider Network Management Workgroup
• Accepts other duties as assigned

QUALIFICATIONS
• Minimum of five years’ experience in a Health Plan or Healthcare Provider setting with supervisory responsibilities
• Strong knowledge of commercial and government programs reimbursement methodologies and risk sharing models.
• BS/BA in business administration or health care related field of study or equivalent years of experience
• Ability to use financial and utilization data to formulate rate proposals within budgeted financial targets and evaluate financial impact of changes in payment terms.
• Proficient in Microsoft Word, Excel and PowerPoint.
• Demonstrates solid communication, interpersonal, relationship-building and negotiation skills
• Effectively form and lead cross-functional teams to achieve desired contracting objectives
• Must be ability to lift a minimum of 30 pounds and stand for prolonged periods of time during events

Contact Person: Lydia Chan
Email Address: lydiac@chasf.org
Fax: 4156772404

• Location: San Francisco, San Francisco, California

• Post ID: 52251322 sf
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