Contracts Manager

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

The Contracts Manager is responsible negotiation of contracts and Member specific letters of agreements including but not limited to negotiation of contract rates and terms, timely renewal of all contracts to ensure continued network participation, and any required amendments.  Communication with providers to address and assist with additional needs including all requests for rates increases. Research and follow up on all internal emails sent to the Contracting Department requesting contract/provider information; Supporting the Director of Provider Contracting and Provider Contracting Managers in all required or directed activities.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary.
• Hybrid schedule.
• CalPERS retirement.
• State of the art fitness center on-site.
• Medical Insurance with Dental and Vision.
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development.
• Wellness programs that promote a healthy work-life balance.
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

1. Negotiate and prepare Provider agreements, including schedule renewals and amendments. Ensure that all documentation required for the contract is received timely.
2. Negotiate and prepare Member specific letters of agreement and ensure to maintain letter of agreement regulatory timeliness requirements.
3. Partner with Actuarial Services in developing various payment methodologies and analyzing rate proposals for providers. Perform and monitor on-going financial analysis of contract performance.
4. Work with Contracts Administration dyad partner to ensure accuracy of the contracts management system and that contract inflow and outflow is being maintained.
5. Work closely with other departments to strengthen relationships with network providers, including UM, Hospital Relations, Special Programs, Provider Relations and Network Development.
6. Act as first point of contact for all provider contracting matters. Manage and control the contractual relationship with providers.
7. Monitor provider contracts to ensure terms and conditions are met. Create, negotiate and incorporate contract amendments, renegotiating the contract to accommodate scope changes or changes in organization requirements.
8. Partner with Configuration department to ensure that all reimbursement methodology is supported by system capabilities.
9. Maintain a thorough working knowledge of IEHP products, policies and procedures, contract requirements, and interprets this information to contracted providers.
10. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Education & Requirements 

• Three (3) years of experience in a Managed Care environment, emphasis on Provider contracting. A minimum of two (2) years of direct experience in Provider contracts
• Bachelor’s degree from an accredited institution required
  • In lieu of required degree, a minimum of four (4) years of additional relevant work experience is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above.

Key Qualifications

• Must have a valid California Driver's License
• Thorough knowledge of contracting structures and payment methodologies preferred
• Intermediate understanding and broad application of principles, theories, concepts, practices, and standards in contract negotiation strategies and techniques
• Provider contracting and analytical skills with emphasis on time management, financial analysis, and problem solving
• Microcomputer applications (Microsoft Word and Excel required) for use in all aspects of an office environment
• Excellent communication, interpersonal and organizational skills

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA