Contract Manager II - Sedgwick Claims Management Services, Inc.
Telecommuter, FL
About the Job
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.
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Contract Manager II
PRIMARY PURPOSE: To negotiate and manage complex contracts and agreements (due to state regulations and/or size of provider) with providers; to maintain provider participation within the network; and to expand and develop provider network.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Contracts new and renegotiates existing provider agreements for clients with complex regulatory requirements.
- Manages agreement review and analysis with providers; approves or escalates redlined agreements as applicable.
- Researches and resolves client issues; liaises with internal departments to satisfactorily address provider concerns.
- Advises Client Services on resolutions to escalated client feedback; drafts and provides updates to contract requests from Client Services.
- Maintains reporting to ensure quality providers are recruited for networks, credentialing projects are scheduled and communicated to stakeholders, and necessary documentation is properly tracked.
- Supports Director and leadership by providing feedback and suggestions for improvement.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Travels as required.
QUALIFICATIONS
Education & Licensing
Bachelor's degree from an accredited college or university in a related field preferred.
Experience
Six (6) years of related experience or equivalent combination of education and experience, to include five (5) years of direct provider contracting experience and three (3) years of experience negotiating with large hospitals and health systems required.
Skills & Knowledge
- Strong understanding of direct provider contracting
- Ability to negotiate with large hospitals and health systems
- Excellent oral and written communication skills, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Excellent negotiating skills
- Ability to create and complete comprehensive, accurate and constructive written reports
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
#LI-LT1 #Contracting #Insurance
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.