Associate Provider Contract Specialist

Sanford Health•Fargo, ND

6d•$22 - $35

About The Position

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Works in cooperation with the Provider Contract Specialists and other department and organizational colleagues to deliver superior service to the health plans comprehensive network of affiliated health care providers. This individual is responsible to assist in the provider affiliation and contracting activities for hospital, professional, vendor, care system and/or ancillary providers including: coordination of the provider affiliation and termination process, provider outreach for contractual and regulatory requirements, contract document and timeline management, as well as accreditation initiatives. Coordinates the provider affiliation process and incorporates into an affiliation recommendation in alignment with affiliation standards. Assists in management of the provider termination process, including reporting and internal communications. Partners with Provider Contract Specialist(s) to prepare standard provider contract documents, then tracks provider contracts and amendments from initial draft to full execution. Uploads and catalogs all executed contracts in the contract management database. Coordinates meetings with Business Configuration and Provider Contract Specialists for contract implementation and is present to document implementation plans. Collaborates with credentialing and business configuration staff to implement negotiated contracts and ensure accurate information is entered into the credentialing and payment software. Develops and maintains a contract inventory tool to ensure contract deadlines and requirements are satisfied. Develops and maintains a standard provider reimbursement documentation structure. Conducts initial and follow-up outreach to providers for standard delegated credentialing amendment contracting.

Requirements

Associate degree or 60+ credits in health care, business, marketing, education, or related field, required.
Two years’ experience in a medical group practice or health insurance/Health Maintenance Organization (HMO) environment.
Experience with data entry, customer service, claims processing, billing, provider relations, credentialing or contracting.
Demonstrated proficiency with the Microsoft Office suite, especially Microsoft Excel.

Nice To Haves

Bachelor's degree in business administration, accounting, health care, finance, or related field, preferred.

Responsibilities

Coordination of the provider affiliation and termination process
Provider outreach for contractual and regulatory requirements
Contract document and timeline management
Accreditation initiatives
Coordinates the provider affiliation process and incorporates into an affiliation recommendation in alignment with affiliation standards.
Assists in management of the provider termination process, including reporting and internal communications.
Partners with Provider Contract Specialist(s) to prepare standard provider contract documents, then tracks provider contracts and amendments from initial draft to full execution.
Uploads and catalogs all executed contracts in the contract management database.
Coordinates meetings with Business Configuration and Provider Contract Specialists for contract implementation and is present to document implementation plans.
Collaborates with credentialing and business configuration staff to implement negotiated contracts and ensure accurate information is entered into the credentialing and payment software.
Develops and maintains a contract inventory tool to ensure contract deadlines and requirements are satisfied.
Develops and maintains a standard provider reimbursement documentation structure.
Conducts initial and follow-up outreach to providers for standard delegated credentialing amendment contracting.