Provider Contract Specialist

Elevance Health • Saint Louis, MO

2d • Hybrid

About The Position

The Provider Contract Specialist will be responsible for coordinating the process for new and existing providers joining the network including creating standard contracts for providers as needed. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Requirements

• Requires a H.S. diploma or equivalent and a minimum of 2 years experience with provider contracts, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Strong organizational and time management skills
• 1-3 years experience in a Health Care role
• Strong Communication skills
• MS Excel

Responsibilities

• Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery system
• Prepare the information for timely and accurate submission to the Provider Data Management area
• Ensure updates/changes for existing network providers are interpreted and loaded accurately
• Ensure accurate and timely loading of professional and facility contracts across value based and fee for service agreements for provider solutions
• Works directly with contracting directors and managers to understand what is negotiated and how the negotiated agreement is translated into the company's systems resulting in accurate and timely loading
• Performs internal audit of provider record, ensuring accuracy against rosters
• Serves as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround
• Serve as local market expert supporting (and managing when necessary) the provider onboarding process and provider updates submitted by provider offices within defined market

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical, dental, vision, short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED