Provider Contract Specialist
About The Position
The Provider Contract Specialist supports the Managed Care / Network Management Department. The role processes new contracts, provider additions, updates or changes, and terminations for primary care physicians, specialists, ancillary vendors, hospitals, and independent providers across the IPA, Clinic, PACE, DVL-HIV, Independent, and Multipurpose Senior Services Program (MSSP). Requests are typically received from contracted and non-contracted providers through the Provider Line and Provider Support email queue. The position also handles requests from internal stakeholders, including credentialing, marketing, business development, provider data management, and clinic administration.
Requirements
- A four-year college degree in health care or equivalent years of related work experience is preferred.
- Extensive knowledge of managed care, provider network management, or contracting principles is preferred.
Nice To Haves
- A four-year college degree in health care or equivalent years of related work experience.
- Extensive knowledge of managed care, provider network management, or contracting principles.
Responsibilities
- Process new contracts for providers and vendors.
- Process provider additions, updates or changes, and terminations.
- Handle requests from contracted and non-contracted providers received through the Provider Line and Provider Support email queue.
- Process requests from internal stakeholders, including credentialing, marketing, business development, provider data management, and clinic administration.
Benefits
- Medical, dental, and vision insurance
- 403(b) retirement savings plan with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career advancement and development opportunities
- Paid Time Off and holidays
- Paid CME days
- Malpractice insurance and tail coverage
- Tuition Reimbursement Program
- Corporate Employee Discounts
- Employee Referral Bonus Program
- Pet Care Insurance
- The role may qualify for discretionary bonuses or incentives.
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What This Job Offers
Job Type
Full-time
