Contract Administration Supervisor

Contract Administration SupervisorThe primary focus of the Contract Administration Supervisor is to manage the application, credentialing and health plan filing processes, while providing guidance, support and information for payor escalations, interaction with payors and questions related to contractual terms and conditions. The Contract Administration Supervisor is responsible for ensuring that team and individual goals are reached, as well as, ensure timely responses, quality assurance, and adherence to departmental and company policies and procedures, as well as federal and state guidelines including Medicare and Non-Medicare payor requirements.Primary Duties And ResponsibilitiesManage the application, credentialing and health plan filing processes, ensuring that all information is submitted timely and accurately.Provide guidance, support and information for payor escalations, interaction with payors and questions related to contractual terms and conditions.Maintain current records of applicable company and employee information for disclosure, taking all necessary measures to appropriately safeguard confidential and sensitive information.Review payer contracts and prepare contract worksheets and reimbursement analysis documents for legal and executive review.Support in the creation and ongoing maintenance of a database of contractual requirements relative to provider obligations and requirementsMaintain internal reference guides, directories and databases of payer participation, billing and compliance requirements and fee schedules.Review and distribute payer manuals, newsletters, bulletins and memos to applicable departments, communicating pertinent requirements and/or updates.Provide direct oversight of vendor relationships supporting credentialing and licensure to ensure accurate information, as well as no lapse in coverageMaintain website access for users company-wide.Manage deadlines and priorities effectively with scheduled and ad hoc goals and assignments.Manage professional meetings and communications.Maintain all soft and hard copy contract and filing records.Responsible for tracking daily productivity.Ancillary Duties And ResponsibilitiesProvide daily/weekly updates on application, credentialing, licensure, and contract status to RCM Leadership, as well as applicable stakeholdersComplete work assignment of Payor Relations/Contract Management to designated team membersMonitor Contract Management processes to ensure adherence to departmental and company policies and procedures, as well as federal and state guidelines including Medicare and Non-Medicare payor requirementsWork collaboratively with the Finance and Legal/Compliance to ensure timely review of contracts and fees schedulesSupport the Contract Management team as subject matter expert, providing guidance where applicable; Researching and resolving issues identified in relation to health plan participation as well as, communicating and/or escalating issues and areas of opportunity to leaders in other departments to ensure resolution.Assist and support RCM Leadership in the development, documentation, implementation, and management of policy/procedures and revisions that are responsive to changes in internal protocol.All other projects and tasks as assignedReporting Relationship ResponsibilitiesProvides work direction plus has responsibility for hiring, promotions, transfers, performance management, discipline, and discharge.Minimum RequirementsEducation:High School Diploma or GED requiredExperience:Minimum 2 years of experience in healthcare credentialing, provider enrollment, payer contracting, or revenue cycle managementMinimum 1 year of supervisory or team lead experience, including responsibility for work direction, performance management, and employee developmentDemonstrated experience managing credentialing and provider enrollment processesExperience with health plan filing and state licensing requirementsTechnical Knowledge:Working knowledge of CAQH and PECOS enrollment systemsBasic understanding of Medicare and commercial payer participation requirementsIntermediate proficiency with Microsoft Office Suite (Word, Excel, PowerPoint)Experience with database software (Access or similar)Ability to navigate payer portals and online credentialing systemsCore Skills:Ability to read, analyze, and interpret contract language and technical proceduresStrong mathematical skills including ability to calculate contract rates, fee schedules, discounts, and percentagesAnalytical reasoning and problem-solving abilitiesClear oral and written communication skillsAbility to manage multiple deadlines and priorities effectivelyDemonstrated organizational skills and attention to detailPreferred QualificationsEducation:Associate's degree or Higher in Business Administration, Healthcare Administration, or related fieldProfessional certification such as CPCS (Certified Provider Credentialing Specialist), CPMSM (Certified Professional in Medical Services Management), or similar credentialing certificationExperience:3+ years of progressive experience in healthcare credentialing, provider enrollment, or payer contracting2+ years of supervisory experience with direct responsibility for hiring, promotions, performance management, and disciplinary actionsExperience working with multiple payer types including Medicare, Medicaid, Commercial Insurance, and Managed Care OrganizationsPrevious experience reviewing payer contracts and conducting reimbursement analysisExperience managing vendor relationships for credentialing and licensure servicesBackground working in a multi-state healthcare organization or with multi-state provider credentialingTechnical Knowledge:Advanced knowledge of Medicare and Non-Medicare payor requirements and compliance guidelinesExpertise in contract language review and reimbursement methodologies (fee-for-service, capitation, value-based arrangements)Experience with call center telecommunications software (Softphones or similar)Familiarity with revenue cycle management systems and credentialing software platformsKnowledge of state-specific licensing requirements across multiple jurisdictionsUnderstanding of federal and state healthcare compliance regulations (HIPAA, Stark Law, Anti-Kickback Statute)Advanced Skills:Proven ability to conduct payer escalations and resolve complex contractual issuesExperience developing and implementing departmental policies and proceduresStrong stakeholder management skills with demonstrated ability to collaborate across Legal, Compliance, Finance, and Operations departmentsAdvanced analytical skills including ability to forecast workflow processes and identify process improvement opportunitiesExperience with employee coaching, productivity tracking, and team developmentDemonstrated group presentation skills and ability to conduct effective meetingsTrack record of maintaining quality assurance standards while meeting productivity goalsExperience creating and maintaining contract databases and internal reference materialsLeadership Competencies:Proven ability to serve as a subject matter expert and provide guidance to team membersExperience managing team performance metrics and daily productivity trackingStrong decision-making skills with ability to escalate issues appropriatelyDemonstrated success in building and maintaining high-performing teamsPhysical DemandsWhile performing the duties of this job, the employee is frequently required to talk or hear, walk, sit; use hands to finger, handle, or feel. The employee is occasionally required to stand.

The employee must occasionally lift and/or move up to 10 lbs.Work EnvironmentWhile performing the duties of this position, the employee performs tasks in a temperature-controlled office environment under normal office conditions. The noise level in the work environment is usually moderate. The work environment involves minimal exposure to hazards or physical risks, which require following basic safety precautions.DisclaimerThe above job description is meant to describe the general nature and level of work being performed; it is not intended to be an exhaustive list of all responsibilities, duties, and skills required for this position.

The Company officers, mid-level, and entry level management staff may assign additional duties and responsibilities as needed. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related duties requested by their supervisor in compliance with Federal and State Laws.At BD, we prioritize on-site collaboration because we believe it fosters creativity, innovation, and effective