Contracting Operations Specialist
About The Position
The Contracting Operations Specialist supports the day-to-day administration and operational management of healthcare contracts throughout the contract lifecycle. This position coordinates contract intake, review, execution, renewals, amendments, and terminations; maintains accurate contract records and data across multiple systems; and monitors key contractual dates, requirements, and deliverables. The Contracting Operations Specialist works collaboratively with Contracting, Credentialing, Revenue Cycle, Compliance, Legal, Finance, and clinical operations to support accurate implementation and administration of provider, payer, and/or vendor agreements. The position also supports regulatory and audit readiness, reporting, process improvement, and the development and maintenance of contracting procedures and documentation.
Requirements
- High school diploma or equivalent.
- 3+ years of progressively responsible administrative or operational experience in healthcare contracting, provider relations, managed care, credentialing, healthcare operations, contract administration, or a closely related area.
- Experience maintaining detailed records, coordinating workflows, and working with data across multiple systems.
- Working knowledge of healthcare contracting and contract administration principles, practices, and terminology.
- Knowledge of managed care operations, provider networks, payer/provider relationships, and healthcare reimbursement concepts.
- General knowledge of applicable healthcare regulatory, accreditation, and payer requirements, including CMS, DMHC, NCQA, and health plan requirements, as applicable.
- Ability to review and interpret contract provisions, rates, effective dates, renewal provisions, amendments, and other contractual requirements.
- Ability to maintain accurate contract records and ensure consistency and integrity of data across multiple systems.
- Strong analytical, organizational, problem-solving, and critical-thinking skills.
- Ability to track multiple contracts, deadlines, deliverables, renewals, and competing priorities simultaneously.
- Ability to develop and maintain reports, dashboards, tracking tools, standard operating procedures, templates, and other operational documentation.
- Strong attention to detail and demonstrated ability to identify discrepancies and resolve data or documentation issues.
- Ability to effectively coordinate work across multiple departments and communicate contract requirements to internal stakeholders.
- Ability to exercise sound judgment, maintain confidentiality, and appropriately handle sensitive and proprietary information.
- Strong written and verbal communication and interpersonal skills.
- Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and Teams.
- Ability to work independently as well as collaboratively in a team-oriented environment.
Nice To Haves
- Associate’s or Bachelor’s degree in Business Administration, Healthcare Administration, Health Services, Finance, Contract Management, or a related field.
- 4+ years of healthcare contracting or managed care experience.
- Experience with provider and/or payer contracts, contract lifecycle management, amendments and renewals, contract implementation, healthcare reimbursement or rate data, audit/compliance support, and contract management or related healthcare information systems.
- Experience with contract management, credentialing, claims, provider data, or other healthcare information systems.
Responsibilities
- Coordinate contract intake, review, execution, renewals, amendments, and terminations.
- Maintain accurate contract records and data across multiple systems.
- Monitor key contractual dates, requirements, and deliverables.
- Support accurate implementation and administration of provider, payer, and/or vendor agreements.
- Support regulatory and audit readiness, reporting, process improvement, and the development and maintenance of contracting procedures and documentation.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
