Provider Contract Administrator

Premera Blue Cross

4d•$58,600 - $93,800•Remote

About The Position

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare. Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/. We have an opening for a Provider Contract Administrator! The Provider Contract Administrator manages all aspects of the provider contract including development of system logic and requirements for the generation and retention of network contracts in the Provider Information and Contract Management system. Development, maintenance and distribution of contract template documents, with the development of appropriate procedures for using the documents, ensuring all contract documents loaded to the repository are compliant. Acts as the point of contact for all issues and questions related to the contract document process. Collaborating across Health Care Economics, Legal, Pricing Configuration, Provider Information, and Provider Network Management &Solutions to ensure all interest are met as well as moving the contracting process along. In addition, they are responsible for the accurate development, issuance, and regulatory filing of custom provider and facility contract documents for the most complex Premera and LifeWise provider arrangements.

Requirements

High school diploma or GED. (Required)
Four (4) years of experience to include: (Required)
Three (3) years of experience contract processing, and/or technical writing with legal/regulatory research.
Two (2) years of experience researching health plan regulatory requirements, such as HIPAA, COBRA, and state insurance requirements.

Nice To Haves

Strong Microsoft Office skills. (Preferred)
Experience with XML. (Preferred)
College degree in related field. (Preferred)
Demonstrated training/auditing skills. (Preferred)
Four (4) years of experience in the healthcare insurance field including medical terminology knowledge. (Preferred)

Responsibilities

Manage the contract library by uploading and configuring XML contract templates with appropriate variables and alternate terms for use by employees creating provider specific contracts.
Test contract templates, troubleshoot issues, partner with the system vendor as needed, and define a schedule for library maintenance.
Create and implement efficiencies with Contract Library.
Communicate all contract library changes and updates to all users.
Interpret contract requests from Network Management for the development, issue, execution, and activation, while ensuring compliance of provider contracts for complex provider groups and facilities.
Manage timelines and deliverables for contracts and OIC filings.
Support implementation of new provider networks; including participation in cross-departmental implementation work groups.
Research, analyze and provide interpretation on complex and abstract contracting issues.
Collaborate with other Premera/LifeWise departments to ensure that benefit and administrative provisions for assigned contracts are consistent with contractual intent and regulatory requirements and have appropriate approvals.
Complete required state regulatory filings for assigned contracts.
Serve as the primary resource in resolution of regulator issues and inquiries related to those filings.
Identify and resolve contract and compliance issues relating to implementation of customized contracts.
Develop and maintain a strong positive collaborative relationship with partner departments.
Lead and/or participate in cross-departmental work groups as required in carrying out new network, product, benefit, policy implementation functions and process improvements.
Train and mentor Contract Specialists.
Perform other duties as assigned.

Benefits

Medical, vision, and dental coverage with low employee premiums.
Voluntary benefit offerings, including pet insurance for paw parents.
Life and disability insurance.
Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.
Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.
Generous paid time off to reenergize.
Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.
Employee recognition program to celebrate anniversaries, team accomplishments, and more.
For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.
Commuter perks make your trip to work less impactful on the environment and your wallet.
Free convenient on-site parking.
Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.
Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.
Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.
Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.