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Contract Specialist PSJH

Providence Health & Services

Irvine, CA 92604
  • Construction / Skilled Trades
  • Healthcare
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Job Details

**Providence St. Joseph Health is calling a Contract Specialist PSJH to our location in Irvine, CA.**
We are seeking a **Contract Specialist PSJH** who will be responsible for understanding, interpreting and solving complex issues arising from Agreements with payers. Intakes managed care operations issues, develops action plans and resolves operational issues within defined time parameters. Responsible for maintaining the accuracy and integrity of the contract documents within contract management system and shared drives. The incumbent performs all duties in a manner that promotes Providence mission, values, and philosophy. (I think we should include our core values here if its important enough to us, lets list it.) In all aspects, he/she serves as a role model for the values and mission of the organization.
**In this position you will have the following responsibilities:**
+ Work closely with key stakeholder to resolve operational issues in specified timeframe related to payer and provider contracts.
+ Strong understanding of contract structure and terms. Serves as facilitator for the resolution of complex contract interpretation. Interfaces with payors on disputes related to contract interpretation.
+ Strong communication skills, both written and oral required to research, identify root cause by communicating at various levels within the organization, consolidating the issues, and sharing the resolution.
+ Strong organization skills required to manage and prioritize work including multiple priorities at the same time. Tracking and communicating current workload and open issues on a regular basis to key stakeholders and leaders.
+ Upon request, may participate with negotiators during contract negotiations, on payer issues.
+ Attention to detail required for the implementation of the executed agreements, including ensuring downstream departments impacted have been notified, and documents are loaded into contract management system and shared drives accurately and completely.
+ Track issues identified by Revenue Cycle and other stakeholders, where system is unable to be set up correctly to administer language correctly. In collaboration with key stakeholders, develop correction action plan.
+ Support the annual payer contract renewal, CDM and payer notification process
+ Support routing of contracts and single case agreements for signature and distributes to key stakeholders in timely manner
+ Ensures contracts are loaded timely and accurately into both shared drive and Contract Management System
+ Responsible for overall contract document maintenance
+ Other duties as assigned
**Required qualifications for this position include:**
+ Associate's degree or equivalent education/experience
+ 2 years experience with payer billing, collections and reimbursement methodologies and contract language requirements
**Preferred qualification for this position include:**
+ Bachelor's Degree
+ Proficient with Microsoft Office Suite
**About the department you will serve.**
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence St. Joseph health from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
**We offer a full comprehensive range of benefits - see our website for details**
**Our Mission**
As expressions of Gods healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
**About Us**
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
**Schedule:** Full-time
**Shift:** Day
**Job Category:** Contracting
**Location:** California-Irvine
**Req ID:** 253657
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