Details: Department: Provider/Database Shift: Days Hours: M-F, 8 am - 5 pmMore than 3 years of experience required HEALTHCARE PARTNERS MEDICAL GROUP is a top-rated California medical group in clinical excellence and patient satisfaction. Founded in 1992, we have grown to provide care for nearly 580,000 patients in over 800 neighborhood medical offices throughout the Los Angeles Metro area. Our more than 4,600 primary care and specialist physicians represent the diversity of the areas we serve. HealthCare Partners also owns and operates urgent care/after-hours care centers, ambulatory surgery centers, and a medical spa. We also have operations in Florida and Nevada that are renowned for their patient care satisfaction and patient outcomes. HealthCare Partners has been recognized nationally for healthcare innovation, excellence, and a top place to work. We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all. If you're looking to make a difference with a large, financially stable, well recognized, privately-owned Medical Group, HealthCare Partners may be the employer for you. Voted One of the 'Best Places to Work in Los Angeles in 2011.” As part of our continued growth, we are currently seeking to add: CONTRACT SPECIALIST 3 OVERVIEW OF POSITION: Responsible for the identification and negotiation of contracts with physicians and ancillary providers in geographically diverse areas for both existing and developing provider networks. Ensure proper administration of the contracts through assessment of provider needs, coordination of contract documentation, and interfacing with MCA, Claims, Care Management, IMCS, and other departments. ESSENTIAL FUNCTIONS: • Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer. • Assesses and completes provider contracting needs for all provider operations. • Provides guidance to Contract Specialists, Contract Coordinators and/or other staff in the absence of Manager, Provider Contracting. • Prepares supporting documentation, negotiates and implements contracts physicians and ancillary providers in geographically diverse areas for both existing and developing provider networks. • Coordinates the completion of provider pre-contractual activities including the submission of relevant provider contract documentation, completion of RFP’s and application information, financial analysis, Regional Accountable Team discussions, credentialing, etc. • Assists Regional Negotiator with preparing and/or coordinates financial and utilization analyses to develop recommendations for compensation methodologies and amounts, including capitation. • Cultivates positive working relationships with network Medical Directors and other administrative staff. • Develops and maintains client relationships and ensures continuing client satisfaction. • Assists in constant analysis of contracting needs. • Negotiates disputed claims to obtain a mutually satisfactory recommendation for settlement. • Responds to correspondence and other communication in a professional and timely manner. • Coordinates contract documentation to ensure timely re-negotiation of existing contracts. • Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. • Performs additional duties as assigned. EDUCATION: • 1 or 2 years of post-high school education or a degree from a two-year college. • Bachelor’s degree preferred. EXPERIENCE: Minimum: • Over 3 years and up to and including 5 years of experience. Preferred: • 5 years of healthcare experience in contracting or management. KNOWLEDGE, SKILLS, ABILITIES: • Computer literate. • Knowledge of Microsoft applications (Excel, Word). • Excellent verbal and written communication skills. • Ability to work independently. We offer a competitive salary and benefits program including Health, Dental, Vision, employer-matching 401(k), Continuing Education, Tuition Reimbursement, free Basic Life and AD&D insurance, company paid Long Term Disability, a generous Paid Time Off schedule, and more.
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