Specialist, Provider Contracting Operations

The Provider Contracting Operations Specialist will assist with maintaining all contract templates, policies and procedures, and coordinate the delivery of documentation with other business units to ensure cohesion.

Assist with reviewing and delivering onboarding provider data. Work closely with the Provider Contracting department to assist with various tasks to ensure consistency is taking place across the department deliverable

This position is 100% Remote.

Job Responsibilities / Duties

• Attend project strategy meetings as the SME and ensure deliverables are met and completed in a timely manner.
• Understand Provider Contracting’s operational processes to develop policies, procedures, and training materials.
• Understand the organization’s contracting system to draft, monitor, and maintain the Provider Contracting department’s SOPs, policies, and job aides, and act as a SME to support the training of designated users on how to load, update, maintain, and pull reports from the contracting database.
• Track and document assignments from initiation through completion
• Support contracting data application upgrades, and auto loads in conjunction with IT support.
• Perform user acceptance testing.
• Draft, redline, and manage contract templates and ensure regulatory compliance.
• Create and manage correspondence templates.
• Create and Manage reference library.
• Assist with other duties as assigned.

Minimum Education :

• Associates degree or five years of relevant contract negotiation or operations experience required.
• Bachelor’s degree in Business Administration or similar field of study preferred.

Minimum Experience :

• Contracting administration and negotiations in a managed care environment required.
• Excellent verbal and written communication skills.
• Detail oriented and analytical.
• Strong organizational skills.
• Ability to manage multi-level and complex organizational structures.
• Managed Care operations and regulatory requirements for all lines of business.
• Industry knowledge of FFS and capitation contractual arrangements with Primary Care and Specialist providers.
• Knowledgeable of Commercial, Medicare, Medicaid lines of business

Req. Certification / Licensure : None.