Contract Specialist

Company : Onpoint

Job Type : Full Time

Allegan, Mi

Number of Applicants

000+

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Job Description - Contract Specialist

Contract Specialist: OnPoint is seeking an energetic, organized, committed professional to fill a full-time Contract Specialist position. The role of the Contract Specialist is to provide oversight of contracts managed within the OnPoint Provider Network team. The Contract Specialist is responsible for assuring all activities and expenditures comply with and adhere to the budgetary plan approved by OnPoint Management and the Board of Directors. The Contract Specialist will present system improvement recommendations to the Provider Network Manager with emphasis on improving the lives of individuals served while maintaining compliance with requirements. This role is responsible for program planning and system coordination within the provider network, monitoring and evaluating provider network adequacy, negotiating and managing provider contracts, providing oversight of contract-related quality issues, and acting as a liaison between OnPoint and contracted service providers to ensure quality services are delivered while meeting Federal and State standards.

PAY RANGE/BENEFIT PACKAGE:
Salary: starting at $60,844.37 up to $83,965.23 annually - placement above minimum salary is based on experience.

OnPoint Benefits:

401(a) retirement: employer matching
457 retirement
Paid holidays

Benefits effective date of hire:

Medical insurance
Dental insurance
Vision Coverage
Employer funding of Health Savings Account

Employer Paid benefits:

Disability insurance
Life insurance (up to $50,000)
Paid Time Off

QUALIFICATIONS:

Master’s degree in social work, public administration, or related human services field required.
QIDP, QMHP required with a minimum of 1 year experience working with people with developmental disabilities, mental illness and/or substance use disorders required.
Must possess excellent organizational, networking, conflict resolution, communication, and facilitation skills.

Preferred education and experience:

Health and human services degree with full applicable licensure e.g., LMSW.
Certified Advanced Alcohol and Drug Counselor (CAADC).
Experience working within Michigan’s publicly funded behavioral health system with knowledge of service arrays for a variety of populations.
Advanced knowledge of Michigan Medicaid Manual standards, Certified Community Behavioral Health Clinic (CCBHC) requirements, applicable Federal regulations, person-centered planning practices and a working knowledge of contract management principles is preferred.
Understanding of Medicaid services, medical necessity, and eligibility criteria, including level of care determinations.
Lived experience with mental illness, intellectual or developmental disability, and/or substance use disorders is valued.

GENERAL RESPONSIBILITIES:

Manages contract development and negotiations with current and perspective contracted providers, in collaboration with the Provider Network Manager.
Leads the contract management life cycle of assigned contracts from initiation through execution, and contract renewal. This includes maintaining current contract information in the contract management database.
Acts as the key contact and subject matter expert for all contract-related activities within the scope of the provider network team. This includes working with contracted providers to resolve concerns, negotiate payment structures and contract terms and mediate/escalate disputes and issues as needed
Analyzes data to determine provider network adequacy and recommends systemic program adjustments while ensuring the needs of the community are met. Participate in the procurement process as assigned.
Educates and advocates for individuals served to be in least restrictive settings while increasing independence and community inclusion.
Leads OnPoint’s County of Financial Responsibility (COFR) process by coordinating with other Community Mental Health organizations to make financial determinations and request service authorizations, in collaboration with clinical teams and Utilization Management as assigned.
Serves as OnPoint’s Designated Collaborating Organization (DCO) contract liaison as it pertains to Certified Community Behavioral Health Clinic (CCBHC) service delivery within the provider network and contract monitoring, as assigned.
Coordinates with OnPoint’s finance team on the cost of care and development of provider reimbursement methodologies.
Acts as a liaison between the provider network team and OnPoint’s finance, UM, and case management teams to monitor and report on services delivered within the contracted provider network.
Participates in Provider Network Regional Operations Advisory Team (ROAT) and regional Home and Community-Based Services (HCBS) meetings and reports back to internal teams. Also attends SUD ROAT, Autism ROAT and rate setting workgroups, as assigned.
Performs other duties as assigned.

EQUIPMENT/TECHNOLOGY KNOWLEDGE: 

Computer skills including various software programs and applications, including Microsoft Office and Electronic Medical Records (EMR's)
Office equipment including but not limited to fax machine, scanner, copy machine, calculator, printers, etc.

POSITIONS TO BE FILLED: 

One full time positions (40 hours/week)

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Contract Specialist

Job Description - Contract Specialist

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