Contract Coordinator

The Contract Coordinator will support all phases of Network Negotiation and Network development activities within the Central Operations Department.  The position will act as the key support function responsible for researching, analyzing and preparing data to assist the Contractors initiatives. This individual will be responsible for tracking and compiling required data from various sources in order to drive actionable/sound recommendations for the Contractors.

 

Job responsibilities and essential functions:Assist Network Contractor in the development & implementation of evolving strategic contract initiatives through existing monitoring tools. Design and produce internal and external communications. Work with interdepartmental representatives to establish plans for issue resolution. Communicate and negotiate plans for issue resolution with Contracted Network Providers and resolve conflicts in a manner that will ensure provider satisfaction. Analyze provider data identifying network gaps- Utilizing proprietary reports and competitive data. Assist Senior Contractor in identifying network gaps and executing plans for recruitment. Interpret contract terms and applicable rate schedules for medical claim audits and re-pricing inquiries. Resolve provider participation issues related to contracted rates and services. Act as liaison between hospital based provider network and Provider Relations Dept. to facilitate communication regarding claims issues. Respond to inquiries from providers specifically related to the provider contract Prepare report summaries for management

 

The ideal candidate should possess:

Bachelor’s degree or equivalent work experience; demonstrated analytic, dynamic interpersonal, written and oral communication skills; organizational skills with a proven ability to work independently and in team settings; familiarity with healthcare provider data including fee schedules, contracts, and electronic claims submissions; good problem solving skills related to automated systems and operations; strong PC skills.The ability to interact with individuals at all levels of the organization is essential as are communication, presentation and organization skills.