Provider Contract Management Specialist

• Prepares, configures, and maintains provider contract documents and templates in the contract management system.
• Conducts peer reviews and system testing of documents, templates, and configurations prior to production deployment.
• Implements and coordinates provider contracts and reimbursement with Provider Operations, Provider Pricing, and Provider Enrollment staff.
• Works cross-functionally with Network Management, Legal, and Regulatory Compliance teams to draft, coordinate, file, and revise provider contracts.
• Serves as the central point of contact for contract management system training, troubleshooting, and support.
• Maintains the integrity and accuracy of the provider contract database and repository.
• Supports internal and external audits, triages claims and audit inquiries, processes Single Case Agreements, and assists with mass mailings across all Plans.
• Develops and maintains contract policies, procedures, and desk references, enforces business requirements and standards.

• Bachelor's Degree in healthcare, business or related field.
• 3 years experience in the healthcare industry with a minimum of one year project-related experience, or equivalent combination of education and experience.
• Proficient in Microsoft Office and corporate software.
• Strong skills in grammar, formatting, and report preparation.
• Action-oriented with the ability to organize, prioritize, and meet deadlines while producing accurate, detail-focused work.
• Excellent oral and written communication skills for interfacing with internal and external contacts, including state regulatory bodies.
• Strong teamwork and collaboration skills with peers, leadership, and cross-functional teams.
• Proficient in contract management systems, including loading contract types, payment methodologies, document templates, and system reporting.
• Skilled in contract filing software to manage regulatory compliance and state filing requirements accurately.
• Familiarity with the Regence provider community, contracting protocols, reimbursement methodologies, and contract development processes desired.
• Experience with AI tools and technologies to enhance productivity and decision-making highly desired.

Demonstrates expertise in contract management, including preparation, configuration, and maintenance of provider contracts, while ensuring compliance with regulatory standards. Proficient in utilizing contract management systems and Microsoft Office to support cross-functional collaboration and effective communication.

• Contract Management System Proficiency
• Healthcare Industry Experience
• Project Management Skills
• Regulatory Compliance Knowledge
• Strong Communication Skills

• Contract Preparation
• Document Configuration
• Report Preparation
• Contract Filing Software
• Regulatory Compliance
• Provider Contracting Protocols
• Reimbursement Methodologies
• System Reporting
• Audit Support
• Single Case Agreements

• Teamwork
• Collaboration
• Organizational Skills
• Detail-Oriented
• Action-Oriented

• Healthcare
• Provider Operations
• Provider Pricing
• Provider Enrollment
• Network Management
• Legal Compliance
• Contract Development Processes

• Microsoft Office
• Contract Management Systems
• AI Tools and Technologies