• Provider Credentialing Specialist

    FlexStaff (Bronx, NY)


    **Req Number** 171147

     

    Flexstaff is hiring a Provider Contract Specialist to join our client's team. This is a long term assignment.The Provider Contracting Specialist is responsible for the development, negotiation, and management of contracts with providers.

     

    Setting: Hybrid, 1-2 days in office, schedule can change at any time, so flexibility is required.

     

    Pay Rate: $27/hr

     

    Schedule: Monday - Friday 8:30 am-5:30 pm (1 hour lunch)

     

    Contract Length: Temp

    JOB RESPONSIBILITIES:

    + Develop, negotiate, and manage contracts with IPA's, primary care

     

    practices, specialty practices, LHCSA agencies, FQHC's, ancillary

     

    providers, hospital systems and other provider groups.

     

    + Track and monitor provider performance to ensure contracts meet the

     

    organization's objectives, including financial terms, compliance, and

     

    quality of care requirements.

    JOB DESCRIPTION

    + Track and manage contract terms and renewals to ensure timely

     

    execution.

     

    + Administer the on-boarding of new providers through the SCA process,

     

    data enter and update provider contracting tracker (PORF) and Care

     

    Compass. Track and monitor each SCA to ensure the closing of the SCA

     

    through contract conversion or termination.

     

    + Maintain accurate records of contract negotiations, amendments, and

     

    renewals in the contract management system.

     

    + Collaborate with internal teams, including legal, compliance, and

     

    finance, to draft, review, and finalize provider contracts.

     

    + Assess and analyze provider performance and market conditions to

     

    support negotiation strategies.

     

    + Respond to provider inquiries and resolve contract-related issues in a

     

    timely and professional manner.

     

    + Ensure compliance with all relevant federal and state regulations, as well

     

    as organizational policies and procedures.

     

    + Assist in the development of provider networks by identifying new

     

    potential providers and building relationships.

     

    + Monitor and report on key performance metrics related to provider

     

    contracting and network development.

     

    + Provide training and guidance to internal teams regarding contracting

     

    processes and best practices.

     

    + Performs job responsibilities according to organization's policies. Seeks

     

    clarification when needed.

     

    + Assumes responsibility for assignments given, seeks supervision

     

    appropriately, and is accountable for work performance. Meets

     

    productivity guidelines.

     

    + Maintains proper documentation (updated, timely, legible) related to

     

    patient care, whether paper or electronic.

     

    + Maintains HIPAA standards and confidentiality of PHI.

    + Other duties as assigned.

    Service Standards

    + Timely and Accurate Contract Negotiation

    QUALIFICATIONS:

    Education: Bachelor's degree in Business Administration, Healthcare

     

    Management, Finance or related field preferred or equivalent

     

    combination of education and experience.

    Experience:

    + 1-2 years of experience in healthcare provider contracting, managed

     

    care, or a related role.

     

    + Vendor/ provider contracting experience is strongly preferred.

    + Working knowledge of Medicare and Medicaid is required. Health

     

    plan/managed care setting, preferred.

     

    + Experience in administrative support roles that involve data entry,

     

    documentation, or working with data is required.

     

    + Attention to detail, critical thinking, time management skills, a sense of

     

    urgency.

     

    + Strong interpersonal and communication skills with the ability to work

     

    collaboratively across departments.

     

    + Discretion with highly sensitive information, including credentialing files,

     

    sanction lists, claims, and remittance information.

     

    + Attention to detail and ability to maintain accurate records.

    + Excellent organizational and time-management skills.

    + Knowledge of Healthcare regulations (i.e.- HIPAA, CMS, etc.) and a

     

    commitment to patient data privacy and security.

     

    + Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint) and the

     

    ability to learn contract management software quickly.

     

    Additional Salary Detail

     

    The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).

     

    The salary range for this position is $27-$27/hour

     

    It is Northwell Health’s policy to provide equal employment opportunity and treat all applicants and employees equally regardless of age, race, creed/religion, color, national origin, immigration status, or citizenship status, military or veteran status, sexual orientation, sex/gender, gender identity, gender expression, height, weight, disability, pregnancy, genetic information or genetic predisposition or carrier status, marital or familial status, partnership status, victim of domestic violence, their or their dependent’s sexual or other reproductive health decisions, or other characteristics protected by applicable law.