Contract Specialist I
Position Purpose: The key component of this position is to ensure network adequacy through contracting with providers in the geographical areas we service.
- Develop & write contracts and letters of agreements for potential Health providers which meet all AHCCCS, State and Federal requirements, as well as meet all Steward Health Choice requirements relating to quality, services and viability, while ensuring that those agreements meet the operational approval of all internal Steward Health Choice departments prior to execution.
- Implement & establish new contracts and letters of agreement within Steward Health Choice systems, including all necessary updates and notifications to internal departments, AHCCCS and/or any other party needing this information.
- Develop & maintain contract files for all Steward Health Choice provider contracts, establishing files upon the execution of a provider contract, to include all information necessary to meet all AHCCCS and Steward Health Choice requirements.
- Support the contract development & maintenance process by overseeing and coordinating all projects necessary for the upkeep of the Steward Health Choice contracts and agreements, including various tasks that could be ongoing (and periodic) or ad hoc.
- Undergraduate degree or equivalent experience.
Years of Experience:
- 3+ years of experience in a network management-related role, such as contracting or provider services, including experience in utilizing financial models and analysis in negotiating rates with providers.
- In-depth knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS).
- At least an intermediate level of knowledge of claims processing systems and guidelines.
- Excellent verbal and written communication skills; ability to speak clearly & concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
- Strong interpersonal skills, establishing rapport and working well with others.
- Strong customer service skills.