Hybrid Provider Contract Operations Specialist

Posted last week

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About the role

  • Provider Contract Operations Specialist negotiating healthcare provider contracts and managing relationships in health insurance sector. Focusing on compliance and financial terms while ensuring member access.

Responsibilities

  • Analyze financial impact of contracts and terms
  • Maintain contracts and documentation within a tracking system
  • May assist with identifying and recruiting providers based on network composition and needs
  • Communicate contract terms, payment structures, reimbursement rates to providers internal and external members
  • Negotiate and maintain contracts with MSO or primary care providers to ensure our network meets regulatory and business requirements
  • Manage relationships with key providers to support member access, minimize disruption, and maintain competitive advantage
  • Ensure contract terms are implemented and that our organization is protected from risk, both financially and legally
  • Support cross-functional teams with updates on contracting status, rate changes, and network developments

Requirements

  • 2 or more years of experience in negotiating or servicing HMO managed care contracts
  • Proficiency in Understanding of contract terms, payment structures and reimbursement rates
  • Experience with public speaking or presentation skills and with provider facing communication
  • Experience with Value-based Contracting
  • Proficiency in MS Office Word and Excel (IE pivot tables, formulas, v-look up)

Benefits

  • medical, dental and vision benefits
  • 401(k) retirement savings plan
  • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
  • short-term and long-term disability
  • life insurance

Job title

Provider Contract Operations Specialist

Job type

Experience level

JuniorMid level

Salary

$65,000 - $88,600 per year

Degree requirement

Bachelor's Degree

Location requirements

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