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Contract Compliance Officer - MCC of AZ at Magellan HRSC, Inc.

Posted in Management 30+ days ago.

This job brought to you by eQuest

Type: Full-Time
Location: Phoenix, Arizona





Job Description:

Accountable for Profit and Loss, and up-selling of additional membership/markets and/or products, of the assigned account(s), specifically one or more of the key strategic, large, or high risk accounts. Accountable for building day-to-day and strategic operational relationships with customers, particularly the relationships with senior customer management, and setting and carrying out account growth and retention strategies. Interacts on a day-to-day basis with account vendor oversight staff. Develops relationships with other account stakeholders that support achievement of strategic alignment. Partners with and coordinates internal company resources to achieve business objectives, maintain account satisfaction, and ensure that the company's specialty products (i.e., Radiology, Oncology, Pharmacy and Behavioral Healthcare) and services support customers? needs while achieving acceptable margins. Key accounts will typically require strategic alignment with the Corporate division and alignment with local markets.

ESSENTIAL FUNCTIONS:
Customer and Team Management:
- Owns overall account satisfaction for all assigned accounts.
- Develops strong relationships with key operational customers, specifically with the senior leadership of the customers at the Corporate and Local Market levels.
- Provides support and coaching to team members. Works to develop employees? skills, evaluates performance and provides feedback, and oversees resolution of employee relations issues. Manages a high caliber team of employees. Trains employees on products, policies and procedural changes and effectively orients new employees.
- Develops strong relationships and contacts within the company that are supportive of the achievement of customer service requirements including attainment of performance guarantees and minimization of performance penalty expense.
- Fully versed in all aspects of the contracts with assigned customers as well as ensuring ongoing contract performance through risk management activities including assurance of Service Level Agreement performance in Care Management Centers (CMC) and Shared Services, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis and adherence to requirements of the account?s legal and regulatory environment.
- Creates and maintains strategic partnerships with customers through the development and implementation of strategic business plans that result in long term retention of profitable relationships.
- Ensures all Customer and Account-Facing services are provided in a consistent and timely fashion.
- Resolves or appropriately escalates customer service issues in conjunction with operations (claims, service, systems).
- Prepares and presents Joint Operating Committee (JOC) reports for assigned accounts or for area of specialty. Conducts face-to-face meetings with the customer to review JOC reports.
Opportunity Development:
- Aggressively drives up-sell and renewal activities across assigned account(s). For new business and renewals, negotiates rates and contractual terms with customers that result in improved EBITDA.
- Seeks and identifies products and service requirements based on a thorough understanding of each customer?s strategic business goals and the strategic business direction of the product set.
- Demonstrates depth of knowledge of ALL company products and how multiple products are interdependent within the customer contract deliverables and clinical outcomes.
Book of Business and Financial Management:
- Ensures revenue goals are met, cost of care and administrative expenses managed, and (Earnings before Interest, Depreciation, Taxes and Amortization) EBIDTA targets achieved for the assigned account(s).
- Develops and maintains contract compliance tool for periodic assessment of company performance to customer requirements (including performance standards, etc.). Positions the assigned book of business strategically to achieve objectives, including growth requirements, retention requirements, customer satisfaction, etc.
- Proposes final pricing and product description for products sold to existing accounts. Manages risks and develop opportunities associated with underwritten rates.

General Job Information

 

Title

Contract Compliance Officer - MCC of AZ

Grade

29

Job Family

Account Management

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

5/10/2018

Date Requisition Created

5/10/2018

Minimum Qualifications

Education

A Combination of Education and Work Experience May Be Considered. (Required), Bachelors (Required), Masters

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

8+ years broad-based Health Care experience.
5+ years of sales/account management specialty (i.e., radiology, oncology, pharmacy, behavioral healthcare) products and services experience/knowledge.
5+ years direct supervisory experience.
Will substitute an additional 5 or more years of account management, sales or marketing experience in lieu of a formal degree.
Business and organization knowledge and teamwork building skills.
Quantifiable business results.
Service oriented (External and Internal).
Flexible and adaptable.

Competencies

Language(s)

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled