Specialist II, Contract Operations (Remote)
About The Position
The Contract Specialist S4 is a high-impact role within the Payor Partnerships Contract Operations team, responsible for operationalizing and maintaining DaVita’s Fee For Service Agreements. This position manages a high volume of complex contract reviews, requiring the ability to interpret contract language, resolve network issues, understand and provide Rate implementation guidance, navigate and populate the Contractual Lifecycle Management data base and maintain rigorous data accuracy without direct oversight. As an S4-level specialist, this teammate is expected to operate with significant autonomy, utilizing critical thinking and analytical skills to solve complex problems, manage priority payor relationships, and drive resolution on outstanding issues.
Requirements
- High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
- Minimum 2 years of experience in high-volume research, Customer Accounts ownership or complex administrative resolution work.
- Proven track record of top performance in a production-based environment.
- Advanced Excel Skills Required: Must have experience at the formula writing level (e.g., complex IF statements, VLOOKUP, mail merge integration, conditional formatting).
- Strong proficiency in Microsoft Outlook (managing high email volume), Word, PowerPoint, and SharePoint.
- Experience with Salesforce or database management systems preferred.
- Critical & Analytical Thinking: Ability to analyze complex contract and credentialing scenarios and develop solutions without immediate oversight.
- Autonomy: Capable of working independently to solve problems; knows when to escalate issues versus resolving them personally.
- Resilience & adaptability: Can handle high-pressure situations, urgent deadlines, and rapid changes in payor requirements or platform technologies.
- Communication: Strong verbal and written communication skills; able to distill complex issues into clear, actionable updates for stakeholders.
- Efficiency and Prioritization: Can take on a volume of 4500 credentialing Packets annually, in addition to the research and issue resolution cases mentioned above.
Responsibilities
- Accurate and timely contract reviews with regards to Best Demonstrated Performance language, check lists, codes, rates, and credentialing operational language.
- Independently research and resolve complex network and claims issues by collaborating with Credentialing Specialists and Negotiation teams.
- Analyze root causes of delays or denials using tools such as the A3 worksheet format.
- Assess complex situations and communicate effectively to leadership using the SBAR (Situation, Background, Assessment, Recommendation) format.
- Maintain accurate data across multiple systems (Orion, CLM, COR, Salesforce, and IBM-based data systems).
- Strong workflow communication.
- Provide data for weekly reports, including task categories, email volume, out of SLA task assistance and escalation tracking.
- Maintain an average Quality Assurance (QA) score at or above 95% for critical errors.
- Build and maintain strong professional relationships with external payor contacts to facilitate efficient processing.
- Collaborate with internal " Partners" to proactively resolve account issues.
- Working as a collaborative team of Director, Negotiator, Credentialing Specialists, Analyst, and Team Lighthouse to provide specifically tailored Account Customer Service
- Manage an extremely high volume of work, including maintaining email inbox counts below 40 and responding to requests within 1-2 business days.
- Prioritize tasks based on risk and value (e.g., Fee For Service Agreements, Document Reviews, Facility Status Requests, New Center Additions, Acquisitions).
- Resolving 90+% of all tasks within due date or assigned SLA.
- Manage an extremely high volume of work, including maintaining email inbox counts below 40 and responding to requests within 1-2 business days.
Benefits
- Medical, dental, vision, 401(k) match, paid time off, PTO cash out
- Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
