Contract Administrator, System Payer Contracting

Department/Unit:
Integrated Delivery Systems

Work Shift:

Day (United States of America)

Salary Range: $77,075.00 - $

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.

• 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…