Contract Administrator

October 14

🇺🇸 United States – Remote

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

💵 $30 - $37 / hour

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🖥️ Administration

Apply Now

Receive Emails with Similar Jobs

The Princess Margaret Hospital

WebsiteLinkedInAll Job Openings

201 - 500 employees

⚕️ Healthcare Insurance

🧘 Wellness

Description

• Responsible for sustaining and building assigned network with full panel of Primary Care Physicians and Specialists. • Identify network needs and negotiate full agreements and Memorandums of Understandings with providers to ensure availability and accessibility for members. • Produce contract documents with various reimbursement payment methodologies such as Fee for Service, Capitation, Flat rates, and Case Rates. • Conduct remote and field physician recruitment, negotiations, and servicing while partnering with managed care conscious providers. • Coordinate with Medical Management and Network Management in processing provider adds and terminations. • Support credentialing process by collecting documents for new and recredentialing applications.

Requirements

• Document redlining and collaboration with legal team • Determine financial responsibility • Knowledgeable of claims, authorizations, network management, credentialing and eligibility processing and DOFRs/FRMs • Knowledgeable of Medicare and Medicaid fee schedules • Represent company vision and goals during field visits and onsite engagements • 5 years managed care physician contracting negotiations • Four year college degree or higher or equivalent experience • Financial review and contract performance • Capitation compensation negotiations and implementation