On Lok PACE
We are a non-profit committed to our participants.
Dedicated to The Care of Elders:
PACE (Program of All-Inclusive Care for the Elderly) was
developed to answer the many problems around caring for frail
seniors. The PACE model is centered on the belief that it is better
for the well-being of seniors with chronic care needs and their
families to be served in their community whenever possible.
Seniors, their family members, and caregivers face many issues,
including transportation to appointments, management of
medications, coordination of medical care from different
specialists, lack of social interaction, and ability to stay alone
at home. On Lok PACE participants receive in home care services and
transportation to a On Lok PACE center for primary medical care,
social and recreational activities, and other senior care
We understand the importance of a system that works together.
Your expertise, drive and passion can help us carry out our mission
to improve lives and advance healthcare.
Join our team of leaders to begin a rewarding career!
POSITION SUMMARY: Under the direction and supervision of the
Provider Services Manager, the Contract
Administrator negotiates and implements contracts with outside
providing PACE services to On Lok Participants.
DUTIES / RESPONSIBILITIES:
- Effectively negotiate and implement healthcare contracts with
physicians/other professionals, nursing homes and
ancillary (including ambulance, DME, home health/hospice,
imaging, lab, RCFE) providers that meet
reimbursement goals within approved authority limits.
- Develop and maintain working relationships with outside
provider community for both existing provider network
and potential new network providers.
Effectively negotiate and implement individual letter of
agreements within approved authority limits.
Acts as primary point of contact for contract interpretation,
and for contract dispute related to claims inquiry.
Maintains working knowledge of PACE, DHCS and Knox Keene
regulations pertaining to provider contracts.
- Maintains working knowledge of reimbursement methodologies
related to Medicare and Medi-Cal such as
RBRVS, PPS, RUGS and lab/ambulance.
Provides input and participates in strategic planning
Maintain contract files both soft and hard copy format.
- All other reasonably related duties as assigned.
QUALIFICATIONS (knowledge, skills, abilities):
Minimum BA in business, healthcare management or other relevant
Three to five years' experience in a managed care field working
with payors/providers in contract negotiations.
Detail oriented accuracy.
Ability to establish negotiating strategies that leads to
successfully implementing contracts.
Ability to establish priorities and goals including
workflow/project management and organization skills.
Strong communication skills, both oral and written.
Familiarity with Microsoft Office including Excel, Outlook, and
Ability to learn proprietary database(s) such as electronic
medical record and claims payment system.
- Occasional travel to provider locations in SF, Fremont and San
On Lok's Employee Benefits include (eligible for any position
for 20 hr/wk or more):
- Medical, Dental, and Vision coverage
- Retirement Savings Plan 403(b) and Term Life/AD&D
- Flexible Spending Account, Commuter Checks, MLA scholarships,
Employee Assistance Program (EAP)
- Pet Insurance and additional discounts
- Holidays (10 per year), vacation time, sick leave, and
long-term disability insurance
Pursuant to the San Francisco Fair Chance Ordinance, and state
and federal laws (including federal PACE requirements at 42 CFR
460.64(a); 460.68(a), we will consider for employment qualified
applicants with arrest and conviction records.
On Lok is an equal opportunity employer committed to a diverse
and inclusive workforce. All applicants will receive consideration
for employment without regard to sex (including pregnancy), race,
religion, color, gender, gender identity, gender expression, sexual
orientation, national origin, ancestry, disability, medical
condition, genetic information, marital status, age, military or
veteran status, or any other legally protected status.
If you require reasonable accommodation to participate in the
job application or interview process, to perform essential job
functions and/or to receive other terms, privileges or benefits of
employment please contact Recruitment (email@example.com).