What are the responsibilities and job description for the Contract Specialist, Provider position at Altais?
Job Description
Job Description
About Our Company
At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. At Altais, we’re building breakthrough clinical support tools, technology, and services to let doctors do what they do best : care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include : Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.
About Your Team
Are you looking to work with a high performing, fast growing and dynamic provider contracting team? We are 4,000 physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.
About Your Work
As the Contract Specialist, Provider, you will be responsible for supporting provider contracts for all lines of business; Commercial, Medicare Advantage, Medi-Cal HMO and PPO. As part of a cross-functional team, you will work directly with the Contracting Team, Finance, Medical Services, Claims, Configuration, Network Management, Customer Service, Legal, Compliance and our valued providers. You will own the successful implementation and communication of provider contracts.
You will focus on
- Collaborating with the Contracting Department, internal and external stakeholders to support the successful execution of departmental and company goals.
- Complex provider inquiries and / or problems related to operations, contract interpretation (e.g DOFR, delegation), claims, and facilitates resolution. Continuously strive to ensure that favorable relationships are maintained while ensuring the interest of the company.
- Liaison between providers and internal departments which include but are not limited to management, finance, medical services, claims, configuration, network management, customer service, legal, compliance and other internal departments.
- Assist with the planning and scheduling of routine payer joint operations committee meetings with large provider groups and hospitals which may include various internal and external leaders.
- Responsible for developing and / or improving provider contracting existing tools, resources, contract language, physician education resource materials, job aides, policies and procedures (e.g. contracting workflows, value-based contracts, physician resources for billing).
- Manage and participate in the development and implementation of systems (e.g. Symplr / sPayer, Epic) that support network operations and network management to encourage standardization, best practices, and maximize functionality (e.g. automation, report writing, workflows).
- Manage departmental intranet webpages; updating content with tools and resources, ensuring information is continuously up to date and accurate.
- Developing and managing Contracting communications including distribution of fully executed contracts to ensure accurate and timely configuration of contract terms in Epic in efficient manner.
- Contract Management and Maintenance; routing documents for signature, tracking necessary signatures, uploading contracts into database (e.g. Symplr / sPayer).
- With limited supervision, effectively support provider negotiations to achieve contracting strategy and attain budgeted results on a timely basis.
- Responsible for analyzing data while collaborating and / or participating in discussions with colleagues and business partners to identify potential root cause of issues.
- Collaborating with internal stakeholders to develop value-based contracts.
- Driving change and innovation through continually seeking and implementing value added solutions to ensure company goals are met.
- Effectively communicate and advocate providers' needs to internal stakeholders to drive creation of solutions that meet our mutual business goals.
- Understands provider relationships within market and ensures any operational issues are visible to the appropriate parties and works towards a reasonable resolution.
- Assist in the preparation and review of contract documentation by checking for accuracy and analyzing contract terms and history.
- Research, gather, and organize provider contracts for audits, projects, and negotiations.
- Participates in ongoing departmental staff cross-training to provide continuous departmental improvement.
- Completes projects within scheduled time frames and within established standards.
- Solicits information and feedback from operating departments regarding, implementation and performance of contracts as required.
- Administers and creates documents and mailings to providers, as well as contract related mailings.
The Skills, Experience & Education You Bring
You Share our Mission & Values
Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate’s starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.
The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate’s qualifications, skills, and experience.
Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our ‘CPRA Privacy Notice for California Employees and Applicants’ to learn how we collect and process your personal information when you apply for a role with us.
Physical Requirements :
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office / deskwork – Activity level : Sedentary, frequency most of workday.
External hires must pass a background check / drug screen. Qualified applicants with arrest records and / or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
