Contract Manager - Vendor Performance NC Medicaid - Remote

About the position Responsibilities • Responsible for Contract/Vendor Performance. • Serves as the point-person for all Contract management, Vendor performance management, and escalations. • Provides MES Vendor Performance and SLA support to DHHS as defined throughout the Contract. • Negotiates contracts and amendments with Public Network Operators (PNOs), Qualified Service Providers (QSPs), facilities, organizational and/or large group providers, as well as independent practitioners. • Works with other departments as needed for timely completion of annual amendment cycles from beginning to end. • Manages annual re-contracting efforts across departments. • Provides oversight to the Prospective Provider and SCA processes. • Manages the Primary Care Management Module (PCMM) and Rates Governance process to address provider requests for contract modification. • Minimizes situations where retro-active contract modifications are required. • When retro-active implementation is necessary, utilizes streamlined approach to obtain approvals, providing thorough communication to approvers regarding the reason for delay. • Monitors ongoing provider performance changes in cost and utilization needs. • Develops and maintains professional working relationships with providers. • Analyzes contract modification requests and coordinates with the Finance Department on financial impact of any rate/funding changes. • Develops and implements process for monitoring provider contract compliance and performance based contract incentives. • Identifies and implements process improvements to the contract/amendment process as needed. • Ensures that contracts are system compatible, loaded correctly, timely and meet legal and business standards. • Ensures contracts audits are accurate and on time. • Provides supervision/performance management to team of contract coordinators. • Works in concert with other teams to respond to changing or emerging system initiatives; actively participates in RFP re-bid processes as needed. Requirements • At least 10 years of experience managing large service and contracts. • Related professional experience in the managed care, healthcare, or insurance industries. • Analytical/problem solving skills. • Excellent verbal and written communication skills. • Strong PC background and efficient in using standard software. • Knowledge of system process analysis and/or program management, estimating IT system development, and testing. • Experience working in Medicare Operations (for positions supporting Medicare). Nice-to-haves • A combination of education and work experience may be considered. • Bachelor's degree preferred. Benefits • Health insurance coverage • Dental insurance coverage • 401k retirement savings plan • Flexible scheduling options • Paid holidays and vacation time • Professional development opportunities • Employee discount programs • Wellness programs Apply tot his job Apply To this Job