Role Overview: The Contract Account Manager is responsible for supporting contractual compliance and maintaining effective communication between the Health Plan and state regulatory agencies.
Responsibilities:
Investigate, analyze, and respond to inquiries and concerns raised by the Plan and state regulatory agencies.
Monitor, summarize, and communicate changes to contractual requirements, state and federal regulations, and policy updates received through state agency websites or other official communication channels.
Facilitate meetings and collaborate with cross-functional leaders to execute contract requirements and amendments, including ongoing project management to ensure compliance.
Coordinate and prepare for planned and ad hoc onsite or virtual state agency meetings and visits, ensuring timely and accurate submission of all contract deliverables.
Manage communications, reporting, and meetings related to escalated state agency issues, including assigning cases to business owners, tracking metrics, and following up on overdue items.
Participate in internal workgroups focused on contract compliance initiatives in response to state agency-identified concerns.
Manage analysis and communication workflows related to state contract amendments at both the local and enterprise levels.
Coordinate regulatory and operational reporting, including preparation, quality assurance, and submission to state agencies, while providing Plan-level oversight of related issues and communications.
Oversee state contract deliverable submissions, including readiness reviews, reprocurement materials, member and provider communications, and subcontractor or vendor contract approvals, as required.
Represent the Plan in meetings with internal stakeholders and external government or community agencies to resolve operational concerns and regulatory policy issues, while maintaining positive working relationships with state agencies.
Assist with dashboard reporting and performance monitoring trends.
Maintain organized record of state guidance and communications.
Perform other related duties and projects as assigned.
Education & Experience:
Bachelor's Degree preferred, or an equivalent combination of education and experience.
3 to 5 years of experience in managed care, regulatory compliance, operational and regulatory policy updates, or project management.
Medicaid managed care experience preferred
Skills & Abilities:
Strong knowledge of state and federal regulatory requirements and managed care contract compliance.
Demonstrated ability to manage multiple projects and deadlines across functions.
Excellent written and verbal communication skills, including the ability to summarize complex regulatory information clearly.
Possesses excellent organizational, analytical, and problem-solving abilities, along with meticulous attention to detail.
Ability to collaborate effectively with cross-functional teams and external regulatory partners.
Proficiency in reporting, documentation, and compliance tracking processes.
As a company, we support internal diversity through:
Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.
