Contract Operations Manager for LHCSA and CHHA - Personal Touch Home Care

Contract Operations Manager for LHCSA and CHHA

Payor Contract Operations and Credentialing Manager for LHCSA and CHHA 

New Hyde Park, NY

About Us: With 50 years of dedicated service to our communities, Personal Touch has been a trusted provider of home care. Our priority lies in ensuring exemplary patient care while fostering a supportive and empowering workplace culture for all team members. 

Why Choose Us: At Personal-Touch Home Care, we are committed to creating a rewarding and fulfilling experience for our team members. Our established history and reputation provide a stable and trusted foundation for your career. Join us in positively impacting the lives of our patients and their families. As a member of our team, you will enjoy a wide range of benefits that enhance your overall well-being and support your career growth. They include:

• Employee Recognition Programs: We acknowledge and celebrate your contributions.

• Comprehensive Health Benefits: We offer an inclusive package with Medical, Dental, Vision, Accident, and Long-Term Disability Coverage to ensure access to quality medical care while promoting overall wellness. 

• Generous Paid Time Off: We provide generous paid time off to ensure you can recharge and return to work refreshed, leading to greater productivity and job satisfaction. We support a healthy work-life balance. 

• Retirement Benefits: We offer a 401k plan to secure your financial future and help you save for retirement.

• Life Insurance: We offer company paid life insurance providing peace of mind and financial protection for you and your loved ones. 

• Mileage Reimbursement: We make sure you're compensated for your business travel.

• Opportunities for Professional Growth and Development: Empowering you to thrive and grow. 

• Employee Assistance Program: Supporting the well-being of you and your family.

• Perks Program: Exclusive deals and offers on products, services, and experiences you need and love.

Job Summary: The Payor Contract Operations and Credentialing Manager for Licensed Home Care Services Agencies (LHCSA) and Certified Home Health Agencies (CHHA) will play a crucial role in managing and overseeing the administrative and operational aspects related to payor contract management and credentialing. In addition to technical expertise, we are looking for a person who excels in building relationships and fostering a positive, collaborative work environment. The ideal candidate should be a "people person" who is approachable, friendly, respectful, and kind. We value individuals who can communicate effectively with both staff and clients, ensuring a supportive and compassionate atmosphere in all aspects of the role. This role will be reporting to Vice President of Contract and Payor Relations with multi-state oversight.

Job responsibilities

1. Payor Contract Management:

• • Monitoring Contract Compliance: Ensure that all terms of payor contracts are being adhered to by both the agency and the external parties involved.
  • Renewals and Amendments: Track the expiration dates of payor contracts and initiate the renewal process. Implement necessary amendments when changes to services or terms are needed.
  • Documentation: Maintain all documentation related to payor contracts and ensure it is properly organized, stored, and updated.

1. Credentialing:

• • Provider Credentialing: Manage the credentialing process for healthcare providers, ensuring all staff are compliant with regulatory standards. This includes verifying credentials, certifications, licenses, and other required documents.
  • Ongoing Verification: Conduct periodic audits and checks to ensure continuous compliance with credentialing standards.
  • Regulatory Updates: Stay current with changes to regulations related to home care services and ensure the organization remains compliant with multiple State specific Departments of Health (DOH) and other relevant agencies.
  • Insurance Reimbursement: Work closely with billing departments to ensure that the agency is receiving proper reimbursement from insurance companies based on contractual agreements.
  • Dispute Resolution: Address any provider issues or disputes related to contracts and credentialing processes.
  • Cross-Department Collaboration: Work closely with clinical, operations, legal, and finance teams to ensure smooth contract execution and compliance.
  • Reporting: Prepare regular reports for senior management regarding contract status, credentialing updates, and any compliance issues.

Qualifications:

• Bachelor's degree in healthcare administration, business administration, or a related field, or a combination of education and experience.
• 3-5+ of experience in healthcare contract management, credentialing, or a related field within the home care or healthcare sector. Management experience a plus.
• Certification in healthcare compliance (e.g., CHC - Certified in Healthcare Compliance), contract management, or other relevant certifications may be preferred.
• Experience in Home Care:
  • In-depth understanding of the LHCSA and CHHA environments, including federal and state regulations governing these services (such as New York State Department of Health regulations) and other states regulations
  • Experience working with insurance companies, healthcare providers, and government entities.
  • Proven ability to manage complex credentialing processes for healthcare providers, ensuring adherence to required standards.
  • Familiarity with systems and software used in credentialing, such as those used by healthcare agencies and insurance companies.
  • Demonstrated knowledge or experience in billing and reimbursement methodologies of healthcare contracts, including terms of service, rates, payment structures, and compliance with legal standards.
  • Strong attention to detail in reviewing contract terms and ensuring all necessary conditions are met.
  • Knowledge of state and federal healthcare regulations, including those related to home care, patient privacy, and insurance requirements (e.g., HIPAA, Medicaid/Medicare, and other payer systems).
  • Experience ensuring compliance with home care-specific certifications and licenses.
  • Strong interpersonal skills to work effectively with clients, providers, regulatory bodies, and internal teams.
  • Excellent written and verbal communication skills to prepare reports, contract documents, and compliance updates.
  • Familiarity with home care management software, electronic health records (EHR) systems, and credentialing platforms.
  • Proficient in Microsoft Office Suite (Excel, Word, PowerPoint) and contract management systems.

Job Type: Full-time

Pay: $70,000.00-$80,000.00 annually

We are excited to welcome passionate and dedicated individuals to join our team at Personal Touch Home Care. We’re more than just a company, we’re a close-knit family dedicated to supporting each other’s success and well-being. Apply now and join us in making a positive impact on the communities we serve.