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Contracts Specialist

Apply Share Job ID 1207 Category Corporate Functions Job Location Redwood City, California Posted Date 01/18/2019


The Contracts Specialist is responsible for managing the life cycle of payor contracts which include but not limited to commercial, medical group and government contracts for Genomic Health's proprietary lab tests. Reporting to Senior Manager, US Commercial Contracting, responsibility includes the following activities: contract language review; identification and oversight of payor requirements; system implementation and organizational deployment of payor contracts; act as a liaison across all relevant departments who depend upon the accuracy and timeliness of contract provisions; and perform risk assessments of existing contracts. The ideal candidate will be able to perform in a fast-paced environment, able to create and reset priorities as the need arises, identify and raise issues before they become critical, and adjust quickly to the changes of a dynamic organization.

· Conduct compliant, through and appropriate assessment, analysis, redline, negotiation and issuance of basic to moderate level contractual documents. The Contract Specialist anticipate contractual issues and recommend solutions and will support and handle a variety of payor contracts (e.g. new agreements, terminations, letter of agreements, amendments, regulatory agreements, addendums) and related documentation reviews. This role will also review contracts for completeness and accuracy prior to obtaining signatures.
· Collaborate with Managed Care, Billing & Reimbursement, and Finance team(s) to help resolve any contract related issues that require further research of the payor. This requires at times review of the existing contract, provider manual, payor portal and/or medical policies research.
· Manage and evaluate contract request intake forms submitted by the Managed Care team and identify and communicate gaps before contract review process takes place. As needed, create contract evaluation forms and outline critical information which is further utilized in discussions between stakeholders.
· Maintain payor information and key contract terms in contract management system (Apttus). Perform contract evaluations (e.g. identify risk, outline key terms, Genomic Health responsibilities) for existing contracts and assist with data migration of this information into Apttus.
· Engage in critical business discussions with key internal teams/stakeholders (e.g. Senior Contract Managers, Billing and Reimbursement, Finance, Legal, Genomic National Account Managers) early in the contracting process to provide updates, discuss potential operational issues, financial implications and contract requirements.
· Manage payor specific and industry changes related to CPT Code and pricing (includes monitoring the timing, calculations, communications with payors and internal departments). This includes but not limited to review of State Medicaid fee schedules, Medicare price change impact on managed and commercial payor contracts and CPT Code changes impact on line of business. While adhering SOX compliance, help ensure pricing accuracy is maintained at all times for new and existing payor contracts.
· Lead process improvements or other projects that enhance and streamline contracting processes, systems, tools and other resources.
· Act as a resource within the team for fellow team members and other departments.
· Ability to manage special projects and other duties as assigned.

· BA/BS required.
· 5+ years of contracting experience within the healthcare industry; 1-2 years payor contracting experience is highly desired.
· Strong understanding and/or experience with commercial managed care payors and reimbursement process.
· Understanding of market-related issues, contract development, negotiation, and pull through as well as the legal and regulatory implications associated with commercial and government payor contracting.
· Excellent communication skills, both written and oral.
· Ability to work independently as well as collaboratively with all internal and external partners and stakeholders.
· Team player with strong interpersonal skills and ability to build effective working relationships throughout all levels of the organization.
· Strong attention to detail and organizational skills.
· Ability to present recommendations supported by analytical evaluations.
· Familiarity with contract management system (Apttus) and CRM system (Salesforce).
· Proficient in computer applications such as Microsoft Office Suite.


The Contract Specialist is responsible for managing the life cycle of payor contracts which include but not limited to commercial, medical group and government contracts for Genomic Health’s proprietary lab tests.
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If you want to be part of a team that prides itself in teamwork and developing cutting-edge technology at Genomic Health, apply today!