Healthcare Reimbursement: Contract Oversight and Renewal

$15.00

Format: On demand

Duration: 200 Mins

Instructors: Coral MED

Learning Credits: 0.2 CEU

*This course was updated on Oct 31, 2025.

Description

This unit focuses on the operational and strategic management of payer contracts after execution, ensuring ongoing compliance, performance tracking, and relationship maintenance. Learners will explore how healthcare organizations monitor key contract terms, manage renewals, and utilize tools such as dashboards, calendars, and compliance checklists to ensure adherence to contractual obligations. The course emphasizes proactive communication with payers, performance data utilization for renegotiation, and integration of equity-driven practices to promote fairness and inclusion in contracting processes. Learners gain hands-on skills in developing a contract management plan tailored to organizational goals and regulatory standards.

1. Describe the ongoing tasks involved in managing payer contracts post-execution. 2. Identify best practices for tracking contract terms, performance requirements, and key dates. 3. Utilize tools (e.g., contract calendars, dashboards, checklists) for effective contract oversight. 4. Explain the importance of regular communication with payers to resolve issues proactively. 5. Assess how contract performance data informs renegotiation strategies. 6. Develop a simple contract management plan tailored to a healthcare organization. 7. Apply equity-driven strategies to contracting processes and decisions.

After completing this unit, learners will be able to: • Implement structured methods for managing payer-provider contracts after execution. • Track and document key contract milestones, renewals, and compliance deadlines. • Use technology-driven tools for monitoring performance and ensuring transparency. • Maintain professional communication with payers to address emerging issues. • Analyze contract data to support performance reviews and renegotiations. • Design and present a basic contract management plan for a healthcare organization. • Apply equity and inclusion principles to ensure fairness and ethical contracting practices.

• Foundational Knowledge of Healthcare Reimbursement systems or equivalent knowledge of payer contracts. • Familiarity with basic contract terminology, performance metrics, and legal compliance frameworks. • Prior Knowledge of contracting principles.

• Contract and Compliance Managers overseeing payer agreements and renewals. • Revenue Cycle Leaders ensuring alignment between contracts and reimbursement accuracy. • Managed Care Administrators responsible for maintaining provider network contracts. • Healthcare Executives and Financial Officers managing payer performance and regulatory adherence. • Policy Analysts and Legal Counsel evaluating contractual fairness and compliance. • Graduate students in Healthcare Administration, Law, or Public Policy preparing for management roles.