Contracts Specialist

Job Title: Contracts Specialist

505 City Parkway West Orange CA 92868

Need Locals (Southern Ca)

Position Information:

• Department: Contracting
• Work Arrangement: Full Office
• Work Schedule: Monday through Friday 8:00 a.m. - 5:00 p.m.

Duties & Responsibilities:

• 95% - Contract Support
  • Participates in a mission driven culture of high-quality performance with a member focus on customer service consistency dignity and accountability.
  • Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.
  • Evaluates out of network requests from medical management assesses in-network providers for redirection and attends daily staff meetings to discuss outcomes.
  • Negotiates single patient agreements for members directed out of network and serves as a point of contact for provider inquiries.
  • Updates and reviews desktop procedures and identifies opportunities for improvement.
  • Assists Contracts Managers with contract creation distribution and collection of outstanding contract documents.
  • Maintains electronic library of provider contacts and contracts on shared drive and contract management system/database.
  • Responds to inquiries regarding contract status network rosters provider reimbursement and application/credentialing status in a timely manner.
  • Keeps department management abreast of issues and concerns regarding contracts projects and tasks.
    
• 5% - Other
  • Completes other projects and duties as assigned.

Minimum Qualifications:

• Associate degree PLUS 2 years of work experience related to managed care or related field required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Preferred Qualifications:

• Experience negotiating single patient agreements professional and ancillary contracts.
  Experience with elementary data analysis.

Required Licensure / Certifications:

• N/A

Knowledge & Abilities:

• Develop rapport and establish and maintain effective working relationships with leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize be analytical problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g. Microsoft Office: Word Outlook Excel PowerPoint) and job specific applications/systems to produce correspondence charts spreadsheets and/or other information applicable to the position assignment.