Director of Contract Compliance HHSI at Harbor Health Services, Inc.

Boston, Massachusetts, United States -

Full Time

Start Date

Immediate

Expiry Date

08 Sep, 26

Salary

154058.0

Posted On

10 Jun, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Contract Management, Compliance Oversight, Vendor Negotiation, Regulatory Compliance, Audit Readiness, Document Control, Strategic Sourcing, Performance Monitoring, Analytical Skills, Time Management, Communication Skills, Microsoft Office 365

Industry

Hospitals and Health Care

Description

Role: The Director of Contract Compliance, oversees the full lifecycle of contract development, execution, and management across corporate operations, Community Health Centers (CHC), and the Elder Service Plan (ESP). This role is responsible for standardizing and centralizing contracts, affiliation agreements, and Business Associate Agreements (BAAs) within a contract management system, ensuring accuracy, accessibility, audit readiness, and compliance with federal and organizational requirements, including HRSA, HIPAA, and CMS regulations. The Director leads document control practices, supports academic affiliation partnerships, and ensures contracts and Memoranda of Understanding (MOUs) clearly defines scope and compliance expectations. Additionally, the Director drives ESP network contracting strategy through vendor sourcing, negotiation, performance monitoring, and compliance oversight, while collaborating cross-functionally to resolve issues, and maintain a high-performing, compliant provider network aligned with operational, financial, and clinical goals. Responsibilities: HHSI * Responsible for developing an executive annual contractor audit and compliance work plan to ensure adherence to federal, state and regulatory bodies. Issues and monitors corrective action plans as needed and coordinates terminations resulting from violation of laws, compliance, and contractual terms. * Directs efforts to standardize, streamline, and centralize all contracts, affiliation agreements, and BAAs within HHSI’s contract management software program for Corporate, ESP and the Community Health Centers. * Ensures all documents are accurately uploaded, categorized, and maintained to support accessibility, audit readiness, and reporting needs. * Develops and enforces document control practices, including versioning, renewal alerts, and periodic audits to ensure completeness and accuracy of the contract repository. Community Health Centers * Responsible for the comprehensive oversight of the end-to-end contracting process across both Corporate and Community Health Center operations. * Ensures all contracts are developed, reviewed, approved and executed in accordance with organizational policies and federal and state requirements, including those set forth by the Health Resources and Services Administration (HRSA). * In conjunction with the VP of Compliance and Risk Management, maintains an accurate and complete Form 5A based on Contracted Relationships per HRSA. * Oversee the development, review and execution of Business Associate Agreements (BAAs) to ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations. * Collaborates closely with the Human Resources department to develop, review, and maintain student affiliation agreements with academic institutions. * Leads the creation, review, and ongoing monitoring of Memoranda of Understanding (MOUs) for the Community Health Centers. * Ensures all MOUs and contracts clearly define scope of services, roles and responsibilities, performance expectations and compliance obligations. Elder Service Plan * Directs the ESP network contracting strategies designed to balance enrollment, operational, financial and clinical goals. * Evaluates use of contracted services and identifies areas of network deficiencies and increased service demand for network expansion. * Sources, develops, negotiates, executes and manages network provider and vendor contracts based on solid knowledge of reimbursement methodologies, system and operational constraints and CMS regulations. * Serves as the primary point of contact and champion for the network and ESP community as it relates to contract maintenance and management, operational, claims submission and implementation issues and questions. * Collaborates with other departments to research and resolve contractual issues. * Coordinates activities and documents required for one-time authorizations (MOUs) to ensure prompt vendor payments. * Maintains accurate list of contracts and contracted personnel required by the CMS audit; validates credentialing of contracted provider when required. * Understands and shares performance/quality metrics in comparison to the network; analyzes, researches, and interprets results, variances, and trends and prepares and communicates analysis and recommendations verbally and in writing to the network and ESP management. * Ensures compliance with CMS regulations and requirements through a contract oversight policy that aligns with other internal policies and procedures. * Maintains regular and punctual attendance. * Performs other related duties as assigned. Requirements: * Bachelor’s degree in related field required; Master’s degree preferred * 5-7 years of related experience in a managed health care environment, with a thorough knowledge of the health care market and the needs/concerns of health care providers * Effective communication and presentation skills, both verbally and in writing * Acumen to negotiate new vendor contracts in coordination with internal stakeholders including Marketing, Finance, Legal and Compliance * Strong analytical skills * Contract negotiation experience is desirable, with ability to understand and interpret all aspects of a contract: financial, legal, and operational with emphasis on implementation of contract terms * Proven time management and organizational skills, and ability to work independently and prioritize multiple demands * Excellent computer skills, including proficiency in Office 365 Word, PowerPoint Excel and Teams. * Must be able to travel in a timely manner to Harbor Health sites, vendor sites and other service provider sites in ESP’s service area as needed. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. The salary range and/or hourly rate listed is a good faith determination of base compensation that may be offered to a successful applicant for this position at the time of this job advertisement. When determining actual base salary and/or rate, several factors may be considered as applicable (e.g. location, years of relevant experience, education, training, and other factors as permissible by law). As such, most offers will not be at the top of the salary range.

Responsibilities

Oversees the full lifecycle of contract development and compliance across corporate operations, Community Health Centers, and the Elder Service Plan. Leads the standardization of contracts and BAAs while ensuring adherence to HRSA, HIPAA, and CMS regulations.