Contracts Admin Sr I

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

The Contract Manager is responsible for facilitating and managing the entire contract life cycle of Managed Care contracts, working closely with Field Managed Care in developing and maintaining agreements that provide medical providers and patients with access to our assays while aligning with Genomic Health's goals and objectives.

- Collaborate with the Field Managed Care team to develop account specific objectives to support the overall, strategic Managed Care business plan, including the potential financial impact of various scenarios.
- Develop contracts/amendments/notifications for Managed Care customers and collaborate with Field Managed Care team in negotiations with payers.
- Facilitate contracts through the contract process including review of documents, obtaining all information necessary to successfully implement the contract, obtaining approvals (including development of business cases for proposed terms), communicating appropriate information to the appropriate parties, and updating all relevant systems.
- Ensure all contractual obligations of all parties are met on a timing basis including data exchange, development of quarterly business reviews, performance milestones or guarantees, re-credentialing.
- Maintain payer information and contract terms in all systems (includes coverage policy changes, criteria validation processes, member lives, revenue status information)
- Facilitate conversations with appropriate departments (e.g. billing and reimbursement teams, finance, customer service) early in the contracting process to provide updates, discuss potential operational issues, and develop and follow up on plans to address such issues.
- Involved in the development of action plans for payers that are non-compliant with payment or other contractual obligations, including analyses of potential impact to revenue.
- Assist in managing payer specific and national price changes (includes monitoring the timing, calculations, communications with payers and internal departments)
- Assist in the development and ongoing maintenance of boilerplates, including facilitating review with appropriate internal parties and legal.
- Coordinate review of any 'non-standard' contract obligations with appropriate parties.
- Assist with the rollout and tracking of mass communications and/or contracts (e.g. new product, price increase, process change).
- Gather and maintain corporate business information from appropriate departments required for provider credentialing with public and private payers and hospitals.
- Synthesize lessons learned and update contracts, processes, systems and/or tools.

- BA/BS required
- 5-10 years contracting experience within the healthcare industry
- Knowledge of and/or experience with private Managed Care payers and reimbursement process
- Understanding of market-related issues, contract development, negotiation, and pull through as well as the legal and regulatory implications associated with Private and Government payer contracting
- Effective communication skills, both written and oral
- Collaborative and works effectively as a team member
- Strong attention to detail and organizational skills
- Strong analytical skills and familiarity with Excel and Access (or similar database)
- Ability to present recommendations supported by analytical evaluations
- Capable of prioritizing and managing several, complex projects at once
- Strong skills with Word
- Knowledge of and/or experience with government Managed Care payers and reimbursement process is a plus
- Knowledge of billing and coding is a plus
- Ability to influence without authority
- Comfortable with web technology / document management systems / account management systems
- Capable of identifying and implementing enhancement opportunities
- Strong communicator with ability to maintain open communication with internal employees, managers and customers as needed
- Able to integrate and apply feedback in a professional manner
- Able to prioritize and drive to results with a high emphasis on quality
- Ability to work as part of a team

- Travel Requirements: <10% Travel
- Ability to work from home
- 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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