Associate Contract Specialist

The Associate Contract Specialist is responsible for coordinating the contractual and operational implementation and ongoing maintenance of Medical provider or vendor contracts for products across all lines of business. This individual monitors compliance with contractual agreements, assists with communication of Point32Health policies, procedures, and new initiatives to network providers, and spearheads efforts to resolve operational issues.

Key Responsibilities/Duties – what you will be doing

• Support contract development efforts for both new and existing providers.
  
• Coordinate all activities related to contract implementation.
  
• Serve as an active resource for partner departments and regarding the operational aspects of contract arrangements.
  
• Establish and maintain protocols to monitor compliance with contractual agreements.
  
• Coordinate information collection and dissemination for new and established network providers, including signed contracts and amendments and appropriate provider database entries and contract implementation processes.
  
• Participate in cross-functional meetings as required; initiate and participate in department projects as necessary.
  
• Participate in Roster Reconciliation Program and facilitate necessary updates with the Provider Enrollment teams.
  
• Other duties and projects as assigned.

Qualifications – what you need to perform the job

EDUCATION, CERTIFICATION AND LICENSURE:

• The position requires a Bachelor’s Degree or equivalent experience.

EXPERIENCE (minimum years required):

• 3-5 years work experience, preferred experience in managed care or other health care environment with knowledge of health care market and needs/concerns of health care.
  
• Experience and familiarity with provider agreements and contracts is preferred.

SKILL REQUIREMENTS:

• 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 and interpret the various aspects of a contract: financial, legal, 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 the nuances of the various product lines and the unique operational and financial features associated with each product.
  
• Requires initiative, sound judgment, and the ability to work independently under pressure in a constantly changing environment balancing multiple priorities.
  
• Requires the ability to learn and apply Point32Health Plan’s policies consistently and seek guidance when necessary.
  
• Must be able to conceptualize and envision the impact of change and seek out efficiencies at work. Must be flexible and a proponent/champion of change.
  
• Excellent interpersonal skills are necessary to develop strong working relationships with internal and external contacts.
  
• Requires excellent diplomacy, oral and written communication skills as well as the ability to coordinate efforts among various departments at Point32Health.
  
• Must be able to work cooperatively as a team member.

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel):

• Must be able to work under normal office conditions and work from home as required.
  
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
  
• May be required to work additional hours beyond standard work schedule.

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where 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.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

This job has been posted by IgnyteAI on behalf of Point32Health. IgnyteAI is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of IgnyteAI 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: R6979

About the Company:
Point32Health