Contract Administration Specialist
Qualified candidates MUST have Managed Care and Provider Relations experience
Health plan experience working with providers a MUST!!
- Local candidates (traveling distance to Plantation, FL) needed as the position requires a site visit to the Corporate/Plantation office 1 day per week, remaining 4 days are REMOTE
- 3+ years experience in Managed Care a MUST
- Bachelors and Healthcare experience required
Here we Grow! Because the need to care for children in this age is growing and changing, we are looking for an intelligent, caring Contract Administration Specialist who will join a mission-driven group that is focused on the health of children and the well-being of the family from an operational perspective. Our healthcare practice has grown from its South Florida roots since 1955 across Texas, California, Arizona, New York and there is more to come. At Pediatric Associates, our employees receive competitive salary, a generous PTO program, competitive benefits including a 401K with a Company match of up to 3.5%. With over 65 years of providing LOVING CARE to our patients, we offer the stability and security of an established practice with the excitement of a growing healthcare organization.
Apply on line, email or call us directly, and learn why this is a rewarding career move for you! This is a wonderful time to join our Big Orange PA Family!
Benefits at a glance:
- 3 Comprehensive Medical Plans
- Part Time Medical Plan
- Basic Life and Accidental Death and Dismemberment (AD&D) Company Paid
- Long Term Disability (LTD) Company Paid
- Short Term Disability (STD)
- Voluntary Term Life Insurance (Employee/Spouse/Child)
- 401K Retirement Plan
- Voluntary Benefit Plans
- Life Assistance Plan (EAP)
- Tuition Reimbursement
- Paid Time Off
- Paid Holidays
PRIMARY FUNCTION: Supports the Managed Care negotiation and contracting processes with responsibility for contract administration functions. This includes maintenance of all contracts, fee schedules, contract overviews, payor correspondence and updates. Ensures and manages the contract execution process.
ESSENTIAL FUNCTIONS OF THE JOB: (This list may not include all of the duties that may be assigned.)
- Manages the contract work flow and administration process through contract execution.
- Ensures accuracy of all payor contracts, Fee Schedules and Contract Overviews and maintains the organization Sharepoint site
- Assists in the development and documentation of fee schedule analysis and databases
- Researches state and federal guidelines and communicates updates which impact the organization
- Acts as an internal liaison between the Managed Care team, all internal departments, and payors with multi state responsibility
- Maintains understanding of Managed Care principals, account management standards, and foundational awareness of payor contracting
- Supports acquisition due diligence processes, special projects, policies & procedure development, and programming within the department to improve department processes and efficiencies
- Maintains internal and outward facing relationships and communication with payors, inter and intra-departmental staff and leaders to achieve position goals.
- Schedules internal and external meetings/conference calls and prepares related agendas and materials. Coordinates meeting room set up including collaborating with IT to ensure all needed technology (phones, webinars, teleconference, etc.) are available and ready in advance of meeting.
- Attends meetings and drafts concise, accurate, and timely meeting minutes for distribution and organize within a repository.
- Maintains department documents and ensures filing is organized and current.
TYPICAL WORKING CONDITIONS:
Working in an office environment. Involves frequent telephone interaction. May require sitting, walking, or standing for long periods; also stooping, bending and stretching for files and supplies. Occasionally lifting files, boxes and items weighing up to 20 pounds or less. Requires manual dexterity sufficient to operate a keyboard, type at 35 wpm, operate projector, copier, and such other office and training equipment as necessary. Must be able to communicate clearly and present to small - large groups. It is necessary to view and type on computer screens for long periods and to work in a high volume environment.
Additional Environmental Conditions & Requirements:
- Indoor work setting
- Ability to Operate a Computer
- Ability to Push/Pull 13lb-25lbs
- Handling/Fingering (ability to manipulate items with the hands and/or fingers)
- Sense of Touch
- Ability to wear Personal Protective Equipment (PPE)
Education: Bachelor’s Degree required in related field or equivalent Managed Care experience (minimum of 3 years).
Experience: Minimum 1-3 years’ experience in healthcare and managed care setting required.
Knowledge, Skills & Abilities
- Excellent interpersonal skills
- Organizational skills
- Strong analytical skills
- Ability to multi-task and work independently
- Interpersonal skills
- Strong MS Office skills required, including MS Word, Excel, Outlook, PowerPoint, and Access.
PERFORMANCE REQUIREMENTS: Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI in accordance with organizational policy, Federal, State, and local regulations.
Beginning October 15, 2021, all new hires must demonstrate they are fully vaccinated for Covid-19 by their first day of employment