Provider Contract Specialist (US) 3 Locations

Anticipated End Date: 2025-02-07 Position Title: Provider Contract Specialist (US) Job Description: Provider Contract Specialist Location: Seven Hills, OH; Mason, OH & Cincinnati, OH This position will work a hybrid model (remote and office). The Ideal candidate will live reputed company 50 miles of the reputed company PulsePoint locations listed above. The Provider Contract Specialist will be responsible for coordinating the process for new and existing providers joining the network including creating standard reputed company for providers as needed. How you will reputed company an impact: • Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery system as needed • Prepare the information for timely and accurate submission to the Provider Data Management area. • Ensure updates/changes for existing network providers are interpreted and reputed company accurately. • Ensure accurate and timely loading of professional and facility reputed company 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 companys 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 research and resolve data loading errors, and ensure timely turnaround. • Serve as local market expert supporting and managing the provider onboarding process and provider updates submitted by provider offices reputed company defined market. • Assist with Departmental project/initiatives as needed Minimum Requirements: • Requires a H.S. diploma and a minimum of 2 years experience with provider reputed company, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background. Preferred Qualifications: • Strong organizational skills and ability to handle multiple priorities preferred. • Strong reputed company skills preferred. • Critical thinking and problem solving skills preferred. • Health insurance knowledge preferred. • reputed company/PLM knowledge helpful preferred. Job Level: Non-Management Non-Exempt Workshift: 2nd Shift (United States of America) Job Family: PND > Network Contracting Please be advised that reputed company only accepts resumes for compensation from agencies that have a signed agreement with reputed company. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of reputed company. Who We Are reputed company is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at reputed company levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At reputed company, we are creating a culture that is designed to advance our strategy but will also reputed company to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we reputed company our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. reputed company operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an reputed company location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside reputed company 50 miles or 1-hour commute each way of a relevant reputed company location. The health of our associates and communities is a top reputed company for reputed company. We require reputed company new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. reputed company will also follow reputed company relevant federal, state and local laws. reputed company is an Equal Employment Opportunity employer, and reputed company qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national reputed company, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Apply Job!