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Associate Provider Network Contract Specialist

Company: Point32Health
Location: Lynn
Posted on: June 24, 2022

Job Description:

The Associate Contract Specialist, under the direction of the Manager, Provider Network Management, is responsible for coordinating the contractual and operational implementation and ongoing maintenance of network provider contracts in conjunction with internal departments, for a designated assignment of hospitals, physician organizations, and medical groups. Assist in efforts to resolve operational issues. Coordinate maintenance of provider information changes (add, terms, changes). The position requires a minimum of 2 3 years in a managed health care environment with knowledge of the health care market and the needs/concerns of health care providers.Key Responsibilities:Essential functions occur simultaneously. The Associate Contract Specialist must be able to appropriately handle each essential function, prioritize them with minimal direction, and seek assistance when necessary. These functions need to be performed on a consistent and regular basis, using good judgment.Essential Functions

  • Support contract development efforts for both new and existing Physician Organizations and Medical Groups. Assist with the development and review of contract documents. Assist with activities related to contract implementation. Serve as a resource for all departments and network providers regarding the operational aspects of contract arrangements.
  • Coordinate information collection and dissemination for new and established network providers, including appropriate provider database and set-up forms. Coordinate maintenance of provider information changes (add, terms, changes).
  • Serve as a contact to resolve operational issues on behalf of network contracts as appropriate. Work with department resources to ensure that issues are clearly articulated, documented, and prioritized. Communicate estimated turnaround times to providers and facilitate resolution internally.
  • Participate in cross-functional meetings as required; initiate and participate in department projects as necessary.Knowledge, Skills, and Abilities:Education
    • This position requires a bachelors degree and 2-3 years work experience.Experience
      • Previous experience in managed health care, credentialing or other health care environments is highly desirable. Experience and familiarity with provider agreements and contracts is strongly preferred. Complexity
        • Must be highly motivated individual with excellent organizational skills to manage large volumes of information and multiple assignments; attention to detail is key. Requires the ability to understand all aspects of a contract: financial and operational with emphasis on implementation of contract terms. Possess strong customer focus and expertise in setting and managing customer expectations. Requires the ability to understand different health plans product lines, and the unique operational and financial features associated with each of these products. The role requires initiative, sound judgment, and the ability to work independently on multiple priorities in a constantly changing environment. Requires the ability to learn and apply Poinr32Healths policies consistently and seek out guidance when necessary.Communication
          • Excellent interpersonal skills are necessary to develop strong working relationships with internal and external contacts. Requires excellent oral and written communication skills as well as the ability to coordinate efforts amongst various departments at Point32Health; must be able to work cooperatively and collaboratively as a team member.Confidential Data:All information (written, verbal, electronic, etc.) that an employee encounters while working at Point32Health is considered confidential. Strict confidentiality is required for all clinical information that one encounters and works with as part of the job. Requires a high degree of confidentiality regarding the financial and provisions associated with contractual agreements as well as Point32Healths initiatives, strategies, and products related contract development. Additional Requirement (Travel, Weekend Hours):
            • Hybrid (in Canton, MA) or Remote (Work from Home) options available for position.What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!Please note: As of January 18, 2022, all employees including remote employees must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.About Us:Point32Health is a leading health and wellbeing organization, delivering an ever-better health care experience to everyone in our communities. Building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.At Point32Health, were working to reshape the world of health care by pushing past the status quo and delivering even more to the diverse communities we serve: more innovation, more access, more support, and healthier lives. And we want people like you on our side to make it even better.This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.Req ID: R4071

Keywords: Point32Health, Lynn , Associate Provider Network Contract Specialist, Other , Lynn, Massachusetts

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