Managed Care Contracts Administrator I

Organization: 
Genomic Health, Inc.
Job Location: 
Redwood City, CA
Job Description: 

The Contracts Administrator works with the Managed Care and Sales Operations teams to develop, implement, and monitor Managed Care contracts to ensure operational effectiveness and that GHI and its customers are in compliance with their contractual obligations, and implementing processes related to commercial pricing. The Contract Administrator will also administer all domestic and international commercial contracts, including distribution agreements.

- Facilitate contracts through the contract process including review of documents, obtaining approvals, updating all relevant systems, ensure all action items completed, and communicating appropriate information to the appropriate parties.
- Ensure all payer information and contract terms are accurate in all systems (includes parent/child relationships, coverage policy changes, revenue status information).
- Maintain and communicate an accounting of all pricing, fee and rebate calculations needed, including timing, special instructions, payment details, etc.
- Assist as needed with calculations of performance-based pricing, fees and rebates.
- Assist as needed with payer utilization and/or claims reports and other data requests required under specific contracts.
- Work with Contract Managers to ensure all obligations of both parties are met, including data exchange, milestones, performance guarantees, re-credentialing.
- Assist in developing and rolling out contracts/amendments/notifications.
- Work with Contract Managers in managing payer specific and global price changes (includes monitoring the timing, calculations, communications with payers and internal departments).
- Coordinate review of any 'non-standard' contract obligations with appropriate GHI parties.
- Prepare and process documents for managed care credentialing and ensure current accreditations and licenses are submitted to entities.
- Gather and maintain corporate business information from appropriate departments required for provider credentialing with public and private payers and hospitals.
- Assist with the rollout and tracking, if needed, of mass communications and/or contracts (e.g. regulation changes, price increase, new product launch, change in process).
- Assist with developing and maintaining an accounting of best practices related to contract execution and administration.
- Collaborate in developing and rolling out new or updated processes related to facilitating documents through the contract process.
- Synthesize lessons learned and update contract processes, systems and/or tools.
- Collaborate with Managed Care and the Sales Operations teams on miscellaneous projects, including light data entry.
- Assist with development and implementation of commercial pricing and contracting policies and strategies and prepare executive committee presentations for contract proposals outside of approved policies.
- Assist in developing reports and analysis regarding pricing to help guide Managed Care contract decisions.
- Manage processes to meet the company's commercial contract obligations surrounding rebates, fees, pricing updates and data transfers to customers.
- Maintenance and validation of all commercial contract data within Contract Management System and any other systems/spreadsheets used for revenue recognition purposes.
- Coordinate processes related to communication and systems updates of corporate price changes.
- Develop business requirements for updating the Contract Management System to meet future needs.
- Work closely with the Business Intelligence team to prioritize reporting needs and develop business requirements.

- 2-3+ years experience as a contracts administrator within the healthcare industry
- Strong attention to detail and organizational skills are critical
- Works effectively as a team member
- Able to prioritize and drive to results with a high emphasis on quality
- Strong analytical skills and familiarity with Excel and Access (or similar database)
- Strong skills with Word and PowerPoint
- Comfortable with web technology / document management systems / account management systems
- Effective communication skills, both written and oral. Able to maintain open communication with internal employees, managers and customers as needed
- Capable of identifying and implementing enhancement opportunities
- Flexible / comfortable with change in a growing company and department
- Able to integrate and apply feedback in a professional manner

TRAVEL, PHYSICAL DEMANDS AND WORK ENVIRONMENT:
- Travel Requirements: <10% Travel
- Standing or sitting for long periods of time may be necessary
- Some lifting (greater than 25 pounds) may be necessary; Facilities, Materials and Engineering employees occasionally must lift at least 50-75 pounds.

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