Primary Care Capitation Contracts Compliance Specialist
About The Position
The Primary Care Capitation Contracts Compliance Specialist provides end to end procurement and contract support for the Primary Care Capitation Pilot and related RHTP initiatives. The Specialist manages RFP/RFI/RFQ processes and vendor agreements; drafts, reviews, and amends managed care plan contracts and downstream provider agreements tied to the pilot; and serves as liaison between legal and business for pilot related questions. This role analyzes contract requirements and special provisions for compliance with applicable laws, regulations, and DHB procedures; and conducts research supporting procurement efforts, organizes audit ready documentation and supports public records requests tracking for pilot related matters. The Specialist coordinates closely with the DHHS Office of General Counsel, including the RHTP Assistant General Counsel and DHB Legal team, to ensure compliance, risk identification and mitigation, ensuring pilot model requirements are effectively implemented through health plan and provider contracts.
Requirements
- Graduation from an appropriately accredited institution for paralegal training and three years of experience as a paralegal
- Bachelor's degree from an appropriately accredited institution and three years of substantive paralegal experience
- High school or General Education Development (GED) diploma and seven years of paralegal experience performing delegated, substantive legal work
- An equivalent combination of education and experience
Nice To Haves
- Ability to perform legal research in accordance with preliminary instructions as to methods or approach, source material available, and policy and precedent of the office.
- Ability to draft and prepare contractual instruments.
- Ability to create contracts which document timelines, deliverables and scopes of work.
- Ability to effectively monitor, track and manage contract requirements and compliance from initiation through closeout.
- Ability to understand and resolve complex problems and to read, interpret and make recommendations based on complex state, federal and Departmental rules, laws, and regulations.
Responsibilities
- Manages RFP/RFI/RFQ processes and vendor agreements.
- Drafts, reviews, and amends managed care plan contracts and downstream provider agreements tied to the pilot.
- Serves as liaison between legal and business for pilot related questions.
- Analyzes contract requirements and special provisions for compliance with applicable laws, regulations, and DHB procedures.
- Conducts research supporting procurement efforts.
- Organizes audit ready documentation.
- Supports public records requests tracking for pilot related matters.
- Coordinates closely with the DHHS Office of General Counsel, including the RHTP Assistant General Counsel and DHB Legal team, to ensure compliance, risk identification and mitigation.
- Ensures pilot model requirements are effectively implemented through health plan and provider contracts.
Benefits
- Health insurance options
- Standard and supplemental retirement plans
- NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis)
- Paid vacation leave
- Paid sick leave
- Paid community service leave
- Paid parental leave
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
