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Provider Contract Specialist

Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

The Provider Contract Specialist is responsible for coordinating the process for new and existing providers joining the network including creating standard contracts for providers as needed.

How you will make an impact:

• Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery system.

• Prepare the information for timely and accurate submission to the Provider Data Management area.

• Ensure updates/changes for existing network providers are interpreted and loaded accurately.

• Ensure accurate and timely loading of professional and facility contracts across value based and fee for service agreements for provider solutions.

• Works directly with contracting directors and managers to understand what is negotiated and how the negotiated agreement is translated into the company's systems resulting in accurate and timely loading.

• Performs internal audit of provider record, ensuring accuracy against rosters.

• Serves as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround.

• Serve as local market expert supporting (and managing when necessary) the provider onboarding process and provider updates submitted by provider offices within defined market.

Minimum Requirements:

• Requires a H.S. diploma and a minimum of 2 years experience with provider contracts, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Microsoft Excel and Office Suite experience strongly preferred

• Experience managing large amounts of data preferred