Provider Contract Spec Mgr (US)
About the position
The position involves managing complex negotiated pricing loads and coordinating the process for pricing arrangements with large health systems and provider groups. The role requires attention to detail and critical thinking skills to ensure accurate and timely updates to provider contracts and data management.
Responsibilities
Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery systems.
,
Prepare information for timely and accurate submission to the Provider Data Management area.
,
Ensure updates/changes for existing network providers are interpreted and loaded accurately.
,
Ensure accurate and timely loading of professional and facility contracts across value-based and fee-for-service agreements for provider solutions.
,
Work directly with contracting directors and managers to understand negotiated agreements and their translation into company systems.
,
Perform internal audits of provider records to ensure accuracy against rosters.
,
Serve as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround.
,
Support and manage the provider onboarding process and updates submitted by provider offices within the defined market.
Requirements
H.S. diploma or equivalent.
,
Minimum of 5 years of experience with provider contracts, plan procedures, and policies, or any combination of education and experience that provides an equivalent background.
Nice-to-haves
Benefits
Merit increases
,
Paid holidays
,
Paid Time Off
,
Incentive bonus programs
,
Medical benefits
,
Dental benefits
,
Vision benefits
,
Short and long term disability benefits
,
401(k) with matching
,
Stock purchase plan
,
Life insurance
,
Wellness programs
,
Financial education resources
Apply Now
The position involves managing complex negotiated pricing loads and coordinating the process for pricing arrangements with large health systems and provider groups. The role requires attention to detail and critical thinking skills to ensure accurate and timely updates to provider contracts and data management.
Responsibilities
Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery systems.
,
Prepare information for timely and accurate submission to the Provider Data Management area.
,
Ensure updates/changes for existing network providers are interpreted and loaded accurately.
,
Ensure accurate and timely loading of professional and facility contracts across value-based and fee-for-service agreements for provider solutions.
,
Work directly with contracting directors and managers to understand negotiated agreements and their translation into company systems.
,
Perform internal audits of provider records to ensure accuracy against rosters.
,
Serve as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround.
,
Support and manage the provider onboarding process and updates submitted by provider offices within the defined market.
Requirements
H.S. diploma or equivalent.
,
Minimum of 5 years of experience with provider contracts, plan procedures, and policies, or any combination of education and experience that provides an equivalent background.
Nice-to-haves
Benefits
Merit increases
,
Paid holidays
,
Paid Time Off
,
Incentive bonus programs
,
Medical benefits
,
Dental benefits
,
Vision benefits
,
Short and long term disability benefits
,
401(k) with matching
,
Stock purchase plan
,
Life insurance
,
Wellness programs
,
Financial education resources
Apply Now