CHW Contract Administrator
4 days ago
Chico
Job DescriptionSalary: $30.00 - $36.00 per hour Job Description Introduction to the Company Home & Health Care Management is the oldest home health care agency in Northern California. Our agency specializes in delivering comprehensive in-home care and case management for older adults, children, and those living with disabilities across many counties. We use a matrix of Medi-Cal, Medicare, private insurance and targeted health programs to find solutions that work for our clients. The Role The Contract Administrator is responsible for overseeing, negotiating, maintaining, and ensuring compliance with all contracts related to the Enhanced Care Management (ECM) department. This role ensures that payer contracts, vendor agreements, leases, and service agreements align with regulatory requirements, agency policies, and financial objectives for Community Health Workers (CHW) and case managers that work with private health insurance plan beneficiaries. Who You Are: You enjoy working in a fast-paced office where your efforts to provide excellent customer service are noticed and rewarded. You are detail-oriented, deadline-focused. You are a self-starter, who can see the bigger picture or end game even though today did not go as planned. You have the ability to interpret regulatory and contractual language, great written and communication skills, and are confident and assertive when negotiating. Ability to work with others at all levels within the organization and collaborate with both internal and external stakeholders. You have experience or educational background in health care, legal or administrative work. Duties: To perform this job, you must be able to perform the following duties successfully: Contract Administration • Draft, review, negotiate, and manage contracts with:, • Insurance payers (Medi-Cal Health Plans), • Vendors and service providers, • Independent contractors and consultants, • Ensure contracts are executed, tracked, renewed, amended, or terminated appropriately., • Maintain a centralized contract management system with key terms, expiration dates, and renewal timelines., • Assure aspects of quality assurance/quality improvement data is collected including client satisfaction surveys., • In coordination with the Human Resources (HR) Department, review and implement tracking of employee training requirements for CHW/ECM staff. Compliance & Risk Management • Ensure all contracts comply with:, • Private Insurance/Health Plan regulations, • State and federal healthcare laws, • Agency policies and procedures, • Identify and escalate contractual risks or non-compliance issues., • Coordinate with compliance, legal counsel, Human Resources and leadership as needed. Financial & Operational Coordination • Review reimbursement rates, payment terms, and contract language for financial impact., • Collaborate with billing, accounting, and operations to ensure contract terms are implemented correctly., • Assist with payer audits, contract inquiries, and dispute resolution., • Assist with payer audits, contract inquiries, and dispute resolution. Communication & Reporting • Serve as the primary point of contact for contract-related questions., • Prepare reports on contract status, renewals, and performance., • Provide leadership with summaries and recommendations related to contracts and payer relationships., • Performs other duties as assigned by the ECM Program Manager, Operations Manager or agency Chief Executive Officer. Required Skill/Knowledge/Qualifications: • Strong contract review and negotiation skills., • Excellent attention to detail and organizational skills., • Ability to interpret regulatory and contractual language., • Effective written and verbal communication skills., • Proficiency with Microsoft Office suite including Outlook, Word, and Excel and type at least 45 WPM., • Ability to handle confidential and sensitive information., • Ability to maintain confidentiality to HIPAA standards., • Ability to work with diverse populations., • Ability to follow through with projects with minimal assistance and supervision., • Ability to prioritize projects, work relatively independently, manage multiple tasks, and meet recurring deadlines., • Ability to cooperate and communicate effectively with health plan representatives, supervisors and co-workers creating a mutually beneficial working relationship., • Has strong work ethics in respect to being at work on time and being reliable., • Maintains personal timecard and submits them weekly., • Observes and adheres to agency privacy and security practices. Essential Requirements: • Minimum of 1 year experience in contract management, healthcare administration, or payer relations (home or community health experience strongly preferred). May consider a bachelors degree in health care administration/finance/business in lieu of experience., • Ability to work with others, at all levels within the organization, and collaborate effectively., • Above-average interpersonal, problem-solving, and written and oral communication skills., • Critical thinking skills and willingness to learn new skills., • Valid California Drivers License., • Eligible to be insured under our liability policy with a clean DMV report., • Your own vehicle and proof of current auto insurance., • Meet the agency Physical requirement of the job. Preferred Skills/ Qualifications • Experience working with legal counsel and compliance teams., • Bachelors degree in Healthcare Administration, Business Administration, Finance, or related field preferred., • Knowledge of Medicare, Medicaid, and managed care contracting. Familiarity with Centers for Medicare/MediCal Conditions of Participation Service Region/ Location/Travel: This is not a remote role and requires you to work in our Chico office with occasional trips to satellite offices in Redding or Sacramento. Schedule: Monday through Friday from 8am to 5pm, with 1 hour for lunch 12pm-1pm. Physical Requirements: Job offer is conditional upon successfully passing a medical exam that tests amongst other things the ability to move, visual acuity, and hearing acuity. Physical requirements for this role specifically include: • Sits, stands, bends, lifts, walks, and moves intermittently during working hours, • Able to lift to 35 pounds without assistance, • Able to drive intermittently, • Primarily office-based with occasional meetings., • Prolonged periods of sitting and computer use. Benefits You will be reimbursed for the mileage you travel from the office to participants homes. You will receive a monthly phone stipend. On the first day of the month following 2 months of employment you will be eligible for health insurance, dental insurance, vision insurance, life insurance, as well as Flexible Spending Account (FSA). Leave accrues starting on your first day of employment, and you can take paid vacation, sick and holiday leave after 90 days. We offer a 401(k) matching up to 4% after 1 year of employment and 1,000 hours worked. Apply If you have an interest in joining our amazing team, we would like to hear from you! Click here to apply online. You can also download the application packet located at and fax completed applications to 530-487-8585 or mail to us at 1398 Ridgewood Dr., Chico, CA 95973, Attention: HR Department. Compensation: Pay range is $30.00 $36.00 per hour.