Contract Administrator

100 Albany Med Health System; City of Albany (NY); On-site; USD 77,075 - 119,466; Full time

Benefits offered by this job

Excellent health care coverage with no copay

Emotional, physical, and mental wellbeing programs

Job summary

100 Albany Med Health System is seeking a Contract Administrator responsible for supporting contracting strategies and negotiating with commercial and governmental payers. The ideal candidate will hold a Bachelor's Degree in Business or Health Care Administration, possess strong negotiation skills, and have 4-6 years of experience in managed care.

The position offers excellent health care coverage and requires a commitment to patient confidentiality and HIPAA compliance.

Qualifications

• 4–6 years in managed care negotiations and managed care network operations required.
• 1–3 years of experience leading complex payer negotiations and mediation.
• Equivalent combination of relevant education and experience may substitute as appropriate.

Responsibilities

• Make data-supported recommendations and support the development of AMHS contracting strategies.
• Negotiate with established and new payers, both commercial and governmental.
• Review proposals and make data-informed recommendations for internal consideration.

Skills

Negotiation

Data analysis

Interpersonal skills

Education

Bachelor’s Degree in Business or Health Care Administration

Master’s Degree in Business or Health Care Administration

Job description

Department/Unit: Integrated Delivery Systems

Work Shift: Day (United States of America)

Salary Range: $77,075.00 - $119,466.00

Position Overview

The Contract Administrator, System Payer Contracting (“Contract Administrator”) makes data‑supported recommendations, supports the development of AMHS contracting strategies, and, as assigned, negotiates with established and new payers, both commercial and governmental.

Responsibilities

• Make data‑supported recommendations and support the development of AMHS contracting strategies.
• Negotiate with established and new payers, both commercial and governmental.
• Support economic and risk assessments in collaboration with System Finance, ensuring implementation and operational performance of contracts consistent with negotiated terms.
• Prepare contract proposals for internal review, and conduct meetings, negotiations, presentations, and other organizational functions as assigned.
• Maintain strong relationships and coordinate operational input across all applicable System departments including Practice and Hospital Administration, Billing, Finance, Information Systems, Utilization Management, Quality, Credentialing, Managed Care Organizations, payer, and other internal and external entities.
• Assist with the development of reporting instruments, including contract performance parameters and profit/loss comparisons by service.
• Develop payer profiles, including membership, market share, financials, products, and volumes at AMHS.
• Travel to affiliate locations such as the Saratoga Hospital, Glens Falls Hospital, and Columbia Memorial Hospital.
• Meet with representatives of payers, managed care organizations, and other agencies to evaluate current contracts or develop new contracting opportunities, including those under Federal and NYS reform for AMHS.
• Review proposals and make data‑informed recommendations for internal consideration in preparation for negotiations.
• Negotiate contract parameters and methodologies in conjunction with the Director or VP for Payer Contracting, preparing and presenting proposals representing AMHS’s position.
• Evaluate and develop proposals, identifying opportunities and risks.
• Present opportunities and risks as directed.
• Collaborate with the Legal and Compliance Department and other departments across AMHS to ensure compliance and implementation capabilities.
• Review terms and performance of each established contract portfolio, making data‑informed recommendations for methodology changes, including value‑based payment initiatives.
• Mediates contract disputes to resolution and ensures compliance with contract provisions.
• Monitor contract renewal dates to ensure appropriate review is conducted.
• Coordinate with Finance and others to ensure timely and applicable contract analyses.
• Review risks and collaborate with Financial Reporting to ensure appropriate modeling.
• Understand all modeling parameters and report on them.
• Educate System‑wide departments, including executive leadership, Finance, Billing, and Practice Administration, on contract matters.
• Respond to requests for further information and follow‑up.
• Plan presentations and meetings, preparing narrative, overheads, and handouts as assigned.
• Ensure accurate reporting in all prepared presentations for documentation and archiving.
• Monitor contract performance, independently collecting data, analyzing, and completing spreadsheets to provide comparative and economic assessments and reports.
• Collaborate with Data Analytics to develop routine reporting instruments for AMHS.
• Maintain broad knowledge of payers in the AMHS market and beyond.
• Assist with gathering current data on all major managed care organizations, including financials, current membership, physician networks, and current/future marketing plans.
• Assists with the development of reporting instruments for the AMHS.
• Maintain the absolute confidentiality of patients and AMHS contracts.
• Promote and contribute positively to System‑wide, intra‑departmental, and inter‑departmental relationships by cooperating with the resolution of conflicts.
• Perform special projects and assignments as requested by the Director or VP for Payer Contracting.
• Assist with IDS Affiliate contracting processes related to payer contracting.
• Keep current on changes regarding Federal and New York State regulations on provision and reimbursement of medical services, including federal and NYS VBP Roadmaps.

Qualifications

• Education: Bachelor’s Degree in Business and/or Health Care Administration required; Master’s Degree in Business and/or Health Care Administration preferred.
• Equivalent combination of relevant education and experience may substitute as appropriate.
• 4–6 years in managed care negotiations and managed care network operations required.
• 1–3 years of experience leading complex payer negotiations and mediation.

Benefits

• Excellent health care coverage with no copay at Albany Medical Center providers.
• Wide array of services and programs to support emotional, physical, and mental wellbeing.

Confidentiality & HIPAA

This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Equal Opportunity

Albany Med Health System is an equal‑opportunity employer.