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Contract Director


Responsibilities:

  • Provide oversight, leadership, management, and skills to set and achieve SURS objectives on a daily basis.

  • Make decisions for the program based on contract requirements.

  • Ensure SURS objectives are met as evidenced by contract monitoring reports from the State and feedback received on SURS deliverables submitted.

  • Meet State-defined recoupment goals each year a must.

  • Supervise the positions of Supervisor, Review Operations and Program Integrity; QA Specialist; Payment Integrity Specialist; Database Analyst; and Administrative Assistant.

  • Oversee scheduling and provision of resources.

  • Use data and reports to determine if current allocation of labor, materials, and time are adequate to ensure fulfillment of the program objectives that result in a satisfied customer, Department of Human Services.

  • Develop and coordinate cost-containment activities, surveillance and utilization review activities, and redrafting Iowa Administrative Code (IAC) as applicable.

  • Confirm SURS processes are revised as updates to utilization review procedures are identified.

  • Initiate communication and correspondence with the State, other contractors, and partners to include presentation when requested.

  • Create or approve correspondence and communication required by the contract.

  • Coordinate with staff to respond to requests for information and referrals.

Requirements:

  • Degree in health care administration, business administration, public health, nursing, health information administration, or related field, or the equivalent experience.

  • Advanced degree preferred.

  • Five years experience in program management experience for government or private sector health care entity, as well as previous experience supervising surveillance and utilization review (SURS), catastrophic case management, and other cost-containment activities for a Medicaid program, other government health care program, or a large health care payer.

  • Possess excellent leadership, management, organizational, computer, and written and oral communication skills a must.

To be considered for this position contact our Personnel Department at 317-347-4500, or e-mail careers@hce.org. Please submit a resume and salary history.