Senior Contract Manager - Managed Care

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

We all have the power to help, heal and change lives - beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

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Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world.

As a Senior International Contract Manager, you will negotiate contracts on behalf of CCF within an assigned business area, evaluate new business opportunities, and manage the administrative, legal, operational, and financial aspects of contract negotiations. In this role, you will contribute to contracting strategy development, including business planning and implementation.

A caregiver in this position works remotely from 8:00 a.m. -- 5:00 p.m.

This role is required to meet with the team annually in Cleveland for a half-day, on-site meeting. Seeking candidates who reside in Ohio, Florida or Nevada.

A caregiver who excels in this role will:

• Negotiate contracts on behalf of CCF within assigned business area.

• Evaluate new business opportunities.

• Manage administrative, legal, operational and financial issues related to contact negotiation.

• Participate in contracting strategy development including business planning and implementation issues.

• Prepare, coordinate and manage contract negotiation process.

• Identify and evaluate opportunities and financial terms for assigned contracts.

• Assess potential legal risk in the context of contract provisions.

• Develop appropriate legal and financial contract language.

• Coordinate and participate in legal review.

• Prepare responses, letters of agreement and key contract provisions.

• Prepare and implement strategies for business growth.

• Identify and target specific areas for development.

• Initiate and develop relationships.

• Track history and progress.

• Serve as the principal contact for third-party payers and internal clients in the development, negotiation and review of proposed agreements.

• Review contractual performance of both parties to ensure compliance with terms and to identify conflicts or changes requiring resolution at contract renewal

• Develop methodology and review models that consistently and objectively evaluate the financial impact of proposals.

• Update methodologies as contract issues change.

• Prepare responses to Request for Proposals (RFP) as required.

Minimum qualifications for the ideal future caregiver include:

• Bachelor’s Degree in healthcare, finance, marketing or related fieldand five years of experience in contract management

• OR High School Diploma / GED or equivalent and 9 years of related experience

• Strong background involving managed care contracting with health systems to include hospital, professional, ancillary services

• Experience with Fee for Service and Value Based negotiations for Commercial, Medicaid, Medicare Advantage and Marketplace plan types

• Understanding of Revenue Cycle and Managed Care Business Operations

• Managed care experience

• Experience across multiple service lines (e.g., heart and vascular, transplant, women’s health)

• Health system-based managed care contracting experience

• Experience with claims payment methodologies and operations

• Hands-on experience negotiating and managing health insurance contracts

• Working knowledge of contemporary healthcare policies, practices, operations and reimbursement methodologies

• Knowledge of physician practice management, hospital administration and operations

• Rate and contract negotiation and influencing skills

Preferred qualifications for the ideal future caregiver include:

• Master's Degree

• 10 years of experience in contract management

• Certified Public Accountant (CPA) or Certified Management Accountant (CMA) (for Finance-related contracts)

• Strategic contracting experience

• Experience with transplant and high-cost drug negotiations

Physical Requirements:

• Ability to communicate and exchange accurate information.

• Ability to perform work in a stationary position for extended periods.

• Ability to work with physical records or operate a computer or other office equipment.

• In some locations, ability to travel throughout the hospital system.

• In some locations ability to move up to 25 lbs.

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment as required for procedures.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/

Please review the Equal Employment Opportunity poster.

Cleveland Clinic is pleased to be an equal employment opportunity employer.