Contracts Manager

California Specialty Pharmacy; Whittier (CA); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k with matching

PTO

Sick Time

Holidays

Job summary

California Specialty Pharmacy is seeking a Contracts Manager to support contract implementation, credentialing, and health plan outreach across multiple states. The role emphasizes growth and CRx duties, including pre-contracting credentialing as needed and processing applications.

You will review contracts and amendments for clarity, track LOAs, complete payer requests, and assist with account management and RCM issues under the VP Managed Care.

Qualifications

• Three (3) years' experience in healthcare contracting and administration.
• Experience with payer contracting and Medicare/Medicaid enrollments in a Managed Care environment.
• High School diploma or equivalent.
• Knowledge of contracting structure and payment methodologies preferred.
• Intermediate understanding and broad application of principles, practices, and standards in contract strategies and techniques.
• Provider contracting and analytical skills with emphasis on time management and problem solving.
• Computer applications (Microsoft Office) for use in all aspects of role.
• Excellent communication, interpersonal and organizational skills.

Responsibilities

• Review and administer contracts and amendments for clarity and compliance.
• Track and record contracts, amendments, and LOAs.
• Access and review credentialing for contract compliance.
• Complete and submit applications and requests from payers.
• Assist with account management, including RCM issues.
• Conduct payer outreach efforts and documentation as directed by VP Managed Care.
• Assist with overall contracting efforts and compliance.
• Conduct research for growth efforts by state and payer.

Skills

Communication

Interpersonal skills

Organizational skills

Contracting analytics

Time management

Problem solving

Healthcare contracting

Education

High School diploma or equivalent

Tools

Microsoft Office

Job description

Company Description

California Specialty Pharmacy (CSP) is a dually accredited leading provider of specialty pharmacy and infusion services. We help patients with complex and rare conditions receive the therapies they need, when and where they need it. With our high-touch personalized approach to patient care, robust clinical management and financial advocacy programs, and unique partnerships with health plans, medical groups, and manufacturers, we positively impact patient outcomes and help manage healthcare costs from end-to-end. Currently, CSP provides services across 17 states and operates four infusion centers.

Role Description

The primary duties of the Contracts Manager are assisting with contract implementation related to credentialing and health plan outreach on a broad scale to ensure greater access, completing applications, Medicare and Medicaid enrollments, and pre-contracting credentialing as needed. In addition, the Contracts Manager will assist with business development outreach and corresponding follow-up and account management activities. The focus of the position is to assist in the growth strategy and overall contracting and credentialing efforts, with majority of the position devoted to growth and CRx duties.

Responsibilities of the Contracts Manager include the following:

Contract and amendment review and administration, including language for clarity and compliance.

Tracking and recording of all contracts, amendments, and letters of agreement (LOAs).

Access and review of all necessary credentialing for contract compliance.

Completion and submission of applications and requests from payers.

Assisting with account management, including RCM issues.

Conducting payer outreach efforts and documentation as directed by VP Managed Care.

Assisting with overall contracting efforts and compliance.

Conduct research for growth efforts by state and payer.

Qualifications

Three (3) years' experience in healthcare contracting and administration, with emphasis on provider

contracting with payers and Medicare/Medicaid enrollments in a Managed Care environment.

High School diploma or equivalent.

Knowledge of contracting structure and payment methodologies preferred.

Intermediate understanding and broad application of principles, practices, and standards in contract

strategies and techniques.

Provider contracting and analytical skills with emphasis on time management and problem solving.

Computer applications (Microsoft Office) for use in all aspects of role.

Excellent communication, interpersonal and organizational skills.

Salary Range: DOE

Benefits: Medical, Dental, Vision, 401k with matching, PTO, Sick Time, Holidays