Associate Contract Specialist

Company: TalentBoost (Point32Health)
Location: Duxbury
Posted on: November 26, 2022

Job Description:

The Associate Contract Specialist is responsible for assisting and supporting in any provider recruiting efforts, coordinating the contractual and operational implementation and ongoing maintenance of Allied Health providers or vendors contracts for plan products, and reporting on progress for any company initiatives involving provider recruitment or network maintenance and support. This individual monitors compliance with contractual agreements, assists with communication of THP policies, procedures, and new initiatives to network providers, and spearheads efforts to resolve operational issues. This individual is also responsible for any assigned administrative tasks related to contract execution and support or management. -KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS

• Support contract development efforts for both new and existing providers. Assist with the development and review of contract documents. Coordinate all activities related to contract implementation. Serve as an active resource for partner departments and network providers regarding the operational aspects of contract arrangements. Establish and maintain protocols to monitor compliance with contractual agreements.
• Coordinate information collection and dissemination for new and established network providers, including signed contracts and amendments and appropriate provider database entries and contract implementation processes.
• Serve as primary contact to resolve operational issues with provider contracts as appropriate. Work with department resources to ensure that issues are clearly articulated, documented and prioritized. Communicate estimated turn around times to providers and facilitate resolution internally.
• Facilitate communication with the provider network by providing clarification, interpretation and guidance regarding THP policies, procedures and new initiatives.
• Participate in cross-functional meetings as required; initiate and participate in department projects as necessary.
• Perform other duties as needed (e.g. mailings, filing, departmental projects, etc.) -QualificationsEDUCATION:
  • The position requires a Bachelor's Degree. EXPERIENCE:
    • This position requires 3-5 years work experience. Previous experience in managed care or other health care environment with knowledge of health care market and needs/concerns of health care providers is highly desirable.
    • Experience and familiarity with provider agreements and contracts is preferred. Proficiency in the use of PC based computers is essential.SKILL REQUIREMENTS:
      • Must be highly motivated individual with excellent organizational skills to manage large volumes of information and multiple assignments; attention to detail is key.
      • Requires the ability to understand and interpret the various aspects of a contract: financial, legal, and operational with emphasis on implementation of contract terms.
      • Possess strong customer focus and expertise in setting and managing customer expectations.
      • Requires the ability to understand the nuances of the various product lines and the unique operational and financial features associated with each product.
      • Requires initiative, sound judgment, and the ability to work independently under pressure in a constantly changing environment balancing multiple priorities.
      • Requires the ability to learn and apply Tufts Health Plan's policies consistently and seek guidance when necessary.
      • Must be able to conceptualize and envision the impact of change and seek out efficiencies at work. Must be flexible and a proponent/champion of change.
      • Excellent interpersonal skills are necessary to develop strong working relationships with internal and external contacts.
      • Requires excellent diplomacy, oral and written communication skills as well as the ability to coordinate efforts among various departments at THP.
      • Must be able to work cooperatively as a team member. -WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel, overtime)Fast-paced office environment handling multiple demands. Moderate use of telephone and extensive use of PC required. Requires that the individual be organized while being readily adaptable to changes in work priorities and business environment.CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Will be exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy and department guidelines/policies and all applicable laws and regulations at all times. -*Essential functions occur simultaneously, therefore, the employee must be able to appropriately handle each essential function, prioritize them and seek assistance when necessary. These functions need to be performed on a consistent and regular basis, using good judgment. Ability to learn and apply company policies consistently, seeking out guidance when necessary, is required.THIS DESCRIPTION IS NOT INTENDED TO BE A COMPLETE STATEMENT OF JOB CONTENT; RATHER IT ACTS AS A GUIDE TO THE ESSENTIAL FUNCTIONS PERFORMED. MANAGEMENT RETAINS THE DISCRETION TO ADD TO OR CHANGE THE DUTIES OF THE POSITION AT ANY TIME. -Commitment to Diversity, Equity & InclusionPoint32Health is committed to making diversity, equity, and inclusion part of everything we do-from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.COVID PolicyPlease note: As of January 18, 2022, all employees - including remote employees - must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law. -About Us:Point32Health is a leading health and wellbeing organization, delivering an ever-better health care experience to everyone in our communities. Building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.At Point32Health, we're working to reshape the world of health care by pushing past the status quo and delivering even more to the diverse communities we serve: more innovation, more access, more support, and healthier lives. And we want people like you on our side to make it even better.This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.Req ID: R5187

Keywords: TalentBoost (Point32Health), Brockton , Associate Contract Specialist, Other , Duxbury, Massachusetts