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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