Provider Contracting Specialist- Temp

Flexstaff is hiring a Provider Contract Specialist to join our client's team. This is a long-term assignment. The Provider Contracting Specialist is responsible for the development, negotiation, and management of contracts with providers.

• Location: Olinville
• Setting: Hybrid, 1-2 days in office, schedule can change at any time, so flexibility is required.
• Pay Rate: $27/hr
• Schedule: Monday - Friday 8:30 am-5:30 pm (1 hour lunch)
• Contract Length: Temp

JOB RESPONSIBILITIES:

• Develop, negotiate, and manage contracts with IPA's, primary care practices, specialty practices, LHCSA agencies, FQHC's, ancillary providers, hospital systems and other provider groups.
• Track and monitor provider performance to ensure contracts meet the organization's objectives, including financial terms, compliance, and quality of care requirements.

JOB DESCRIPTION

• Track and manage contract terms and renewals to ensure timely execution.
• Administer the on-boarding of new providers through the SCA process, data enter and update provider contracting tracker (PORF) and Care Compass. Track and monitor each SCA to ensure the closing of the SCA through contract conversion or termination.
• Maintain accurate records of contract negotiations, amendments, and renewals in the contract management system.
• Collaborate with internal teams, including legal, compliance, and finance, to draft, review, and finalize provider contracts.
• Assess and analyze provider performance and market conditions to support negotiation strategies.
• Respond to provider inquiries and resolve contract-related issues in a timely and professional manner.
• Ensure compliance with all relevant federal and state regulations, as well as organizational policies and procedures.
• Assist in the development of provider networks by identifying new potential providers and building relationships.
• Monitor and report on key performance metrics related to provider contracting and network development.
• Provide training and guidance to internal teams regarding contracting processes and best practices.
• Performs job responsibilities according to organization's policies. Seeks clarification when needed.
• Assumes responsibility for assignments given, seeks supervision appropriately, and is accountable for work performance. Meets productivity guidelines.
• Maintains proper documentation (updated, timely, legible) related to patient care, whether paper or electronic.
• Maintains HIPAA standards and confidentiality of PHI.
• Timely and Accurate Contract Negotiation

QUALIFICATIONS:

Education: Bachelor's degree in business administration, Healthcare Management, Finance or related field preferred or equivalent combination of education and experience.

Experience:

• 1-2 years of experience in healthcare provider contracting, managed care, or a related role.
• Vendor/ provider contracting experience is strongly preferred.
• Working knowledge of Medicare and Medicaid is required. Health plan/managed care setting, preferred.
• Experience in administrative support roles that involve data entry, documentation, or working with data is required.
• Attention to detail, critical thinking, time management skills, a sense of urgency.
• Strong interpersonal and communication skills with the ability to work collaboratively across departments.
• Discretion with highly sensitive information, including credentialing files, sanction lists, claims, and remittance information.
• Attention to detail and ability to maintain accurate records.
• Excellent organizational and time-management skills.
• Knowledge of Healthcare regulations (i.e.- HIPAA, CMS, etc.) and a commitment to patient data privacy and security.
• Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint) and the ability to learn contract management software quickly.

Additional Salary Detail

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).