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About the Role

The Network Contract Specialist-Senior is responsible for various aspects of hospital, physician, facility, laboratory, dialysis, and ancillary contract development and maintenance. This includes preparing and implementing all Network Provider agreements and amendments, coordinating with credentialing and legal departments, and ensuring compliance with state and federal regulations. The role involves assisting with contract negotiations, maintaining provider relationships, and resolving network provider issues.

Responsibilities

Responsible for the development of provider contract agreements and legal documents, ensuring proper language, appropriate lines of business, and integration of correct fee schedules.
Monitor and maintain provider files, ensuring executed contracts or amendments are current, compliant, and completed within set timeframe goals.
Identify and analyze information needed to support contract negotiations.
Prepare appropriate concise information for inclusion in contracts, amendments, letter of agreements or other binding documents.
Represent Network Contract Management department with compliance requirements to develop regulatory adherence processes and initiatives.
Interpret and compile audit information requests from CMS, DOH, and internal departments and develop comprehensive responses.
Peer review assigned Network Provider documentation to ensure all outstanding information is received from team analyst and reimbursement teams.
Responsible for receiving provider requests and ensuring timely processing, including provider outreach and internal department inquiries.
Respond to provider inquiries for contracts, fee schedules or other.
Develop Network Provider network through identification of network need, provider outreach, securing positive relationships, and collaboration with Network Providers.
Contract implementation including coordinating analytics, leading operational tasks and delivering provider servicing.
Ensure that all provider contracts related resource payments and incentives are timely and accurate and that all paperwork is correctly submitted to accounts payable and is received by providers according to the contract provisions.
Collaborate with Family Choice of WNY on strategies for the implementation and program development in skilled nursing facilities as requested by NCM leadership.
Accountable for creating department reference tools, such as tip sheets, standard operating procedures, etc. to support efficiencies in specific team tasks.
Collaborate and provide support and communication with Credentialing, Legal, Provider Network Administration, Reimbursement, Utilization Management, Finance, Claims, Servicing, and other teams.
Communicate effectively with both internal and external representatives.
Participate on cross-functional teams as requested.
Support the strategic goals of Manager, Director, and Senior Leadership in meeting corporate and strategic goals.

Requirements

High school diploma or GED required.
Three (3) years of experience in legal and/or contracting field required.
Strong analytical and critical thinking skills.
Proficiency in recognizing how decisions and processes implemented and designed within the business unit impact and interrelate with other internal business units and external stakeholders.
Excellent oral and written communication skills.
Strong organizational skills and ability to prioritize, multitask, and work in a fast-paced environment.
Project management skills with the ability to complete projects and assignments with minimal supervision.
Ability to understand, interpret and implement all aspects of provider contracts.
Ability to concisely and logically present complex issues verbally and in writing, to interact effectively at all levels and to listen carefully.
Strong interpersonal skills.
Effectively handle diverse assignments under shifting priorities and under tight time frames.
Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Skills

Analytical skills
Critical thinking skills
Decision making
Process implementation
Oral communication skills
Written communication skills
Organizational skills
Prioritization
Multitasking
Project management skills
Interpersonal skills

Location

Williamsville

Work Type

Hybrid

Experience Level

Senior

Education Level

Bachelor's degree preferred
High school diploma or GED required

Salary/Compensations

$65,000 - $75,000 annually

Benefits

Scorecard incentive
Full range of benefits
Generous paid time off

About the Company

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

Equal Opportunity

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.