Contracts Manager

Company: KabaFusion
Location: Cerritos
Posted on: July 30, 2022

Job Description:

KabaFusion is a home infusion company with exceptional employees!KabaFusion is a home infusion company with a national network of pharmacist owned pharmacies with the ability to service 40+ states. While we are known for our expertise in IVIg and SCIg, we also provide acute infusion and nutritional therapies.Our success is the result of teamwork from our dedicated staff who truly believe in putting the "care" back in healthcare. A career at KabaFusion means joining a team that lives by its values and empowers team members to make a difference!What we offer:

• Competitive compensation
• Benefits start on your 1st day of employment
• 401K w/ 4% Match - no waiting or vesting period
• PTO / Floating Holidays / Paid Holidays
• Company Paid Life Insurance
• 3 Employee Assistance Programs (EAP)
• Emerging Leaders Training Program
• Perks--- includes discounts on travel, cell phone, clothing, and more---
• Employee Referral ProgramJOB SUMMARY:The Contracts Manager is responsible for the oversight of the managed care contracts through the implementation of systems, assuring contract compliance, contract data management, and business development as it refers to health plans and payors. Overall field support will include, but not limited to, negotiations, contract interpretations and clarification, case management, education, and resources. It also includes understanding claims and intervention when required as the liaison between KabaFusion and health plans and payors. DUTIES & RESPONSIBILITIES:
  • Contract negotiation/renegotiation with health plans, medical groups, IPAs or other managed care payor sources.
  • Ability to establish and maintain professional business relationships with health plans contract managers.
  • Annual rate negotiations
  • Knowledge/Understanding of Division of Financial Responsibility of payors.
  • Knowledge/Understanding of varies payor product lines.
  • Knowledge of and routine review of contract language.
  • Assure Pharmacies remain fully credentialed with all payors to include management of documents required for credentialing process.
  • Provide assessment and recommendations for contractual operation of managed care patients.
  • Provide training support/resources to the field related to managing/analyzing costs.
  • Knowledge of high-cost medications /supplies/DME and education/review of pharmacy costs to identify exclusions and guidance to AR on collecting.
  • Implement cost reduction measures for the provision of ancillary services of managed care include analysis, recommendations, etc.
  • Assist with creation and implementation of managed care policy and procedures.
  • Update/maintain managed care manuals cost analysis and contracts.
  • Ensure all contracts meet company standards and are fully executed.
  • Facilitate contract negotiations / re-negotiations between health plans, medical groups, IPA's or other managed care payor sources and KabaFusion's reimbursement and finance leadership.PREFERRED EDUCATION & EXPERIENCE:
    • Must possess at a minimum, Bachelor's degree in Business or related experience.
    • Minimum of 7 years of experience in health care industry, infusion experience a plus.
    • At least 3 years managed care contracting, billing and negotiations skills required.#corporate #homeinfusion #contractanalysis #managedcare #billing #negotiating #payors #accountsreceivable #costreduction #manager #supervisor #kabafusion #nowhiring
      
      PI186736096

Keywords: KabaFusion, Cerritos , Contracts Manager, Executive , Cerritos, California