Contracts Administrator at Bristol Elder Services Inc – Fall River, Massachusetts

Contracts Administrator $28.52/hour

Position Summary: The Contracts Administrator (CA) is responsible for coordinating and managing provider services contracts, compliance, and ongoing monitoring to ensure services are delivered in accordance with Bristol Aging & Wellness, Inc. (Bristol) and Executive Office of Aging & Independence (AGE) requirements. This position plays a vital role in maintaining provider relationships, ensuring regulatory adherence, and supporting high-quality, cost-effective service delivery to consumers.

Principal Accountabilities:

• Provider Contracting & Administration:

o Utilizing the Provider Contract Management System (PCMS), the CA coordinates newly proposed and renewed proposed contracts, ensuring required documentation, approvals, and signatures are obtained prior to execution.

o Reviews and verifies provider eligibility, licensure, insurance, certifications, and compliance with AGE standards.

o Ensures rates are in alignment with AGE & MassHealth guidelines.

o Tracks contract, insurance, and license expiration dates and maintains organized and up-to-date provider files utilizing Contract Safe.

o Completes and submits Provider Request Forms for Wellsky for new and existing providers and ensures service and rate accuracy.

o Collaborates with the Finance Department to ensure provider information aligns with billing and payment requirements.

o Maintains and updates the Provider Workbook in a timely manner.

o Ensures proper document retention and secure storage of all provider and contract records in accordance with AGE and Bristol policy.

• Provider Quality Assurance:

o Conducts on-site provider evaluations for new providers within 180 days of contracting and every two to three years thereafter, depending on service type.

o Reviews consumer and worker files for accuracy, documentation, and compliance with AGE Homemaker and Non-Homemaker standards.

o Reviews the volume and nature of provider reports and complaints on a monthly basis, identifies trends or high areas of concern, and reports them to the Quality Director to determine when a Corrective Action Plan (CAP) should be requested from the provider.

o Reviews all provider incident reports for both accuracy and completeness, sends them to providers with clear expectations for response, and ensures all follow-up actions and documentation are completed and filed appropriately.

o Collaborates with the Quality Director to determine when a Department of Public Health (DPH) report is required, completes the report in a timely manner when appropriate, and ensures all information submitted is accurate, professional, and compliant with reporting standards.

o Ensures all providers maintain compliance with 105 CMR 155.000 regulations, HIPAA, and Executive Order 504 data security requirements.

o Reports providers to supervisor if they fail to meet corrective action or compliance standards.

• Provider Communication

o Maintains current contact information for all provider agencies, including administrative, billing, and coordination staff.

o Communicates updates, policy changes, and regulatory reminders to providers through organized email groups and scheduled provider meetings.

o Coordinates and conducts mandatory provider annual training and new provider orientation, reviewing Bristol’s policies on confidentiality, nondiscrimination, emergency procedures, and data security etc.

o Engages providers in ongoing dialogue to resolve billing discrepancies, nursing care plan issues, scheduling conflicts, or service coordination concerns.

o Collaborates with Home Care and SCO program management to address provider performance issues.

o Serves as the point of contact for provider questions regarding all internal/external processes.

o Fosters strong professional relationships to maintain cooperation, accountability, and responsiveness within Bristol’s provider network.

o Attends the monthly Southeast Six Contracts Administrator meeting and AGE’s monthly Contracts Administrator meeting to maintain statewide compliance alignment, share best practices, and stay informed of policy updates.

Qualifications:

Education: Bachelor’s degree in business administration, Human Services, or related field preferred but not required.

Experience:

• Minimum of two years’ experience in contract oversight, provider relations, or compliance oversight within human services or healthcare preferred.

• Knowledge of AGE regulations, contracting procedures, and HIPAA compliance preferred.

• Strong organizational, communication, and analytical skills with attention to accuracy and deadlines.

• Proficiency in Microsoft 365 (Word, Excel, Outlook) and data systems.

Special Skills/Knowledge:

• Attention to Detail: Ensures all documentation and contracts are accurate, complete, and compliant.

• Regulatory Knowledge: Understands AGE, DPH, and data protection standards.

• Communication & Collaboration: Builds effective relationships with providers and internal departments.

• Problem Solving: Identifies and resolves provider or system-level issues efficiently.

This job description is intended to be general, will evolve over time, and is subject to periodic updating. This job description does not constitute a written or implied contract of employment.