Summary: This position drafts and reviews provider contract documents, provides assistance and responds to internal and external inquiries of pertinent regulatory and provider contracting issues. Essential Accountabilities: Works with Corporate Counsel and others in Legal Department to develop draft template provider contracts for all provider types that keep current with regulatory, BCBSA and other entities as necessary for required language and terms. Accountable for drafting and maintenance of other legal documents, maintaining and updating corporate files, and responding to requests from corporate and regional staffs regarding pertinent provider legal issues and forms. Develops and loads provider contracts and manages an on-line inventory system of signed contracts and major contract types and terms. Accountable for all maintenance and development work for this paperless system. In addition, all templates are stored electronically, with appropriate access safeguards, and made available to regional contracting and support staffs as necessary. These templates will be current with all regulatory required language and other requirements. Maintains records and assists in ensuring regional and corporate compliance with major terms in all provider contracts. To this extent, develops and maintains an electronic database of major terms and all signed provider contracts. Acts as a liaison between contract negotiation and legal counsel in relaying regulatory requirements/mandates. Gatekeeper for all contractual requests, and accountable for all contractual updates to legal documents. Accountable for ensuring that company processes are followed during contract negotiations prior to signing off on any contractual document changes. This includes ensuring with regional staffs that all terms to be included in contracts have been sized for dollar impacts, assessed for operational implementation capabilities, and have followed exception processes where applicable. Establishes and maintains requisite legal files consisting of correspondence, and legal documents, and background materials relative to assigned matters. Continuously works to identify and remove barriers to increased productivity, quality, cost effectiveness, and timeliness of operations and customer satisfaction. Oversees technological improvements and the purchase of software for this function. Maintains updated lists of required and desired corporate clauses for provider contracts, and compliance with each by region. May provide guidance to contracting staffs and operation implementation teams, and other internal groups and departments to ensure compliance with state, federal and corporate rules and regulations relative to provider contracting issues. May publish all regulatory requirements affecting provider contracting efforts; establishes training seminars and sessions to ensure that regional and other staffs are trained on these requirements. May publish established company policies and protocols regarding document management processes. Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct and leading to the Lifetime Way values and beliefs. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree