Senior Contracts Consultant

BCBSM • River Park, FL

251d • $77,200 - $127,400

About The Position

As a Senior Contracts Consultant, you will coordinate aspects of standard and non-standard provider contracts for lines of business and provider networks including managed care, open access and point of service delivery systems. This position manages, quantifies, and resolves provider contract disputes in coordination with the appropriate BCBSM staff and the provider. The contracts and all related documents must be written, maintained, updated and issued on a continuing annual basis by this position. This position supports and assists in the management of the provider system documentation and implementation. This position also supports related contracting activity including regulatory compliance, appropriate service area filings, enforcement of contract integrity and security protocols, and contract interpretation.

Requirements

• 4+ years of related professional experience.
• Demonstrated PC skills to include such spreadsheet programs as Excel, Access, Lotus, and other commonly used data management tools.
• Demonstrated communication, writing, and customer service skills.
• Demonstrated history of performance in a variety of work roles in a team setting.

Nice To Haves

• Bachelor's degree.

Responsibilities

• Responsible for the contract renewal process, which includes drafting new contracts and coordination of all contract attachments within the established timeframe.
• Monitor and analyze reports and data.
• Recommends contract changes and resolves disputes.
• Redesign contracts based on trends, legislative or corporate requirements.
• File contracts for approval with appropriate state regulatory authorities.
• Respond to inquiries from regulators.
• Provide training to other divisions on contract administration and regulatory compliance.
• Research and develop guidelines and standards for new provider agreements, pilot programs or demonstration projects with other divisions to assure operational viability.
• Audit and refine existing assumptions and procedures to present recommendation for change.
• Participate in design, development and maintenance of contracting projects.
• Research and responds to internal and external inquiries and audits.
• Facilitate and coordinate communications with all other divisional staff regarding contract administration.
• Act as a liaison for provider settlements and their appeals.
• Other duties as assigned.

Benefits

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree