Contract Manager Healthy Kids

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Full Time Staff South Florida Community Care Network, LLC, Sunrise, FL, US

3 days ago Requisition

The FHK Contract Manager is CCP’s primary contact for the Florida Healthy Kids contract. This role leads client communications and governance, interprets and operationalizes contract and amendment requirements, orchestrates cross‑functional deliverables across CCP departments and subcontractors, and ensures audit readiness and timely regulatory submissions. Success in this role is measured by on‑time, accurate reporting; proactive risk escalation; disciplined closure of audit and corrective actions;

and positive client relationship outcomes

• Bachelor of Science/Arts in Business or other degree in a related medical or business field or equivalent years of experience is required
  • Business Administration (MBA) or Management is preferred
• Three to five (3 to
  5) years in a Managed Care Organization; or other healthcare related field is preferred

• Establish and maintain collaborative working relationship with assigned client(s) and other key industry stakeholders; serve as primary liaison per contract requirements; provide accurate, timely and concise replies to requested data or reports, etc.
• Primary liaison to provide interpretation and guidance to the organization regarding contract requirements, reporting and administration.
• Owns interpretation of FHK contract requirements; decides intake triage, due‑date commitments, and deliverable acceptance prior to submission to the client.
• Analyze, summarize, and guide the implementation of the annual and interim contract amendments in conjunction with appropriate business owners.
• Ensure effective implementation of new and renewing contracts through communication and coordination with other functional areas.
• Coordinate and compose time-sensitive responses to incoming regulatory requests and inquiries/issues reflective of compliance with contract requirements.
• Coordinate ,lead and participate in desktop audits, regulatory responses and site visits by client(s), as per contract.
• Triage provider inquiries on claims, authorizations, and network status; ensure handoffs and closure.
• Develop and maintain relationships with key internal and external stakeholders to ensure successful collaboration.
• Identify and recommend performance improvement opportunities.
• Report potential risks, non-compliance, or alleged contract violations.
• Engage in Quality Management Initiatives including, but not limited to, material approval, complaints, and grievances, etc. (when applicable)
• Lead weekly meeting with the Client(s).
• Participate in the monthly Joint Operations Committee (JOC) meetings to address performance and FHK contract-related items with CCP’s Subcontractors.
• Lead and monitor CCP Subcontractors Corrective Action Plans for FHK contract-related non-compliance issues.
• Develop and present Quarterly Performance Measures report to client(s) (when applicable).
• Liaison between client(s), providers, and Community Care Plan corporate office.
• Serve as the liaison for resolving issues with Community Care Plan’s internal depts, e.g., Medical Economics, Claims, Provider Operations, IT, UM, etc.
• Travel for FHK Board Meetings, presentations, account satisfaction functions, etc., when required

This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

• Proficient in Microsoft Word,…