Provider Contract Management Specialist

Cambia Health Solutions

1d • $28 - $46 • Remote

About The Position

Every day, Cambia’s dedicated team of Provider Contract Managers are living our mission to make health care easier and lives better. As a member of the Network Operations team, our Provider Contract Management Specialists supports the accurate development, execution, and maintenance of healthcare provider contracts, including database management, regulatory filings, and audit support. This role also conducts research to resolve contract-related issues and provides training to internal teams on contract management systems and processes – all in service of creating an economically sustainable health care system. Do you have a passion for system optimization and process improvement? Are you energized by sharing your expertise through mentoring and cross-functional collaboration? Then this role may be the perfect fit.

Requirements

• Bachelor's Degree in healthcare, business or related field and 3 years experience in the healthcare industry with a minimum of one year project-related experience, or equivalent combination of education and experience.
• Proficient in Microsoft Office and corporate software, with strong skills in grammar, formatting, and report preparation
• Action-oriented with the ability to organize, prioritize, and meet deadlines while producing accurate, detail-focused work
• Excellent oral and written communication skills for interfacing with internal and external contacts, including state regulatory bodies
• Strong teamwork and collaboration skills with peers, leadership, and cross-functional teams
• Proficient in contract management systems, including loading contract types, payment methodologies, document templates, and system reporting
• Skilled in contract filing software to manage regulatory compliance and state filing requirements accurately
• Wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
• Access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company.

Nice To Haves

• Familiarity with the Regence provider community, contracting protocols, reimbursement methodologies, and contract development processes
• Experience with AI tools and technologies to enhance productivity and decision-making

Responsibilities

• Prepares, configures, and maintains provider contract documents and templates in the contract management system, including technical coding, sub-coding, and system configuration to ensure accurate contract language, rates, and reporting capabilities
• Conducts peer reviews and system testing of documents, templates, and configurations prior to production deployment to minimize contractual, administrative, and regulatory risks
• Implements and coordinates provider contracts and reimbursement with Provider Operations, Provider Pricing, and Provider Enrollment staff, including annual fee schedule updates
• Works cross-functionally with Network Management, Legal, and Regulatory Compliance teams to draft, coordinate, file, and revise provider contracts in compliance with state Insurance Commissioner requirements
• Serves as the central point of contact for contract management system training, troubleshooting, and support, including developing training materials and conducting virtual sessions
• Maintains the integrity and accuracy of the provider contract database and repository, conducting ongoing audits and communicating updates to Network Management and other divisions
• Supports internal and external audits, triages claims and audit inquiries, processes Single Case Agreements, and assists with mass mailings across all Plans
• Develops and maintains contract policies, procedures, and desk references, enforces business requirements and standards, and assists with stakeholder coordination on contract language, operational standards, and data governance

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level