Contract Coder Jobs in Pittsburgh, PA (NOW HIRING)

GENERAL OVERVIEW:

This job is responsible for activities related to managing and monitoring partner plan services agreements. Oversees all contracts and related performance. Proactively and aggressively monitors the terms of the contracts, coordinates with internal and external legal representation, regulatory, compliance, privacy and other functions, assists in defining amendments and additional statements of work (SOWs), and supports the contract administration infrastructure including related tools, systems, processes, and policies.

ESSENTIAL RESPONSIBILITIES

• Proactively monitor all in-scope contracts and agreements. Monitor contracts, terms, earn-backs, penalties, etc. through metrics, dashboards and frequent reporting. Oversee contractual relationships and related issues and risks. (35%)

• Coordinate and liaise with other functions and related external constituents. Coordinate with internal legal, finance, audit, business, operations, regulatory, compliance, privacy, and other units as necessary for contract related tasks. Participate in governance forums and provide guidance on contractual / commercial issues. Collaboratively work with other functions to ensure timely handling of all contractual issues, disputes, escalations, etc. Coordinate with other functions to actively manage identified contract risks. (30%)

• Manage ongoing administration of in-scope contracts and agreements. Participate in key client contract definition, and finalization activities. Assist in defining amendments and additional SOWs. Ensure business owners review all financial and commercial terms in contract change requests and ensure compliance with business strategy. Manage execution and implementation of amendments, additions, deletions to all contract documents. Manage contract review, approval and contract signature process. (25%)

• Support contract administration infrastructure, including draft designs and oversee execution of all contract administration related tools, systems, processes, etc. Review and maintain contract administration policies and procedures. Evaluate, assess and recommend ongoing improvements to the contract administration function (including all related tools, systems, processes, etc.). (10%)

• Other duties as assigned or requested.

QUALIFICATIONS:

Required

• Bachelor's degree in Finance, Business Management or Pre-law or relevant experience and/or education as determined by the company in lieu of bachelor's degree.

• 5 years of experience in Contract administration

Preferred

• Master's degree in Finance, Business Management or Law

• 3 years of experience in Negotiation

SKILLS:

• Meaningful experience in contract and commercial management - i.e., development, execution and management of strategic client contracts, business cases, scenario planning / modeling and financial / commercial risk analysis

• Ability to manage through ambiguity and a matrixed environment

• Good Commercial and legal understanding of services contracts

• Excellent relationship building and relationship management skills

• Excellent communication and presentation skills (both oral and written)

• Ability to manage and monitor outstanding tasks

• Excellent drafting skills for structuring ideas in a clear and concise manner

• Strong project management and effective time management skills

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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