What are the responsibilities and job description for the Contract Specialist position at American River Healthcare?
Job Description: Contract Specialist
Position: Contract Specialist
Department: Operations
Location: American River Healthcare
Reports To: VP of Office Operations
Overview:
American River Healthcare is seeking a detail-oriented and experienced Contract Specialist to join our team. This role will be responsible for managing a wide range of contracts, including insurance agreements and business contracts (e.g., phone services, printers, shredding), while also overseeing the recredentialing and renegotiation processes for insurance contracts. The Contract Specialist will play a key role in ensuring favorable terms and compliance across all contractual relationships and will help drive operational efficiency across the organization.
The ideal candidate will possess strong contract management skills, a deep understanding of healthcare-related contracts, and excellent negotiation abilities. This position requires an individual who can work independently and ensure that all contracts are in line with American River Healthcare's business objectives and regulatory requirements.
Key Responsibilities:
- Contract Management & Oversight:
- Oversee the full lifecycle of contracts, including initiation, negotiation, execution, and compliance for both insurance and business contracts.
- Draft, review, and manage contracts with vendors, service providers (e.g., phone, printers, shredding), and insurance companies.
- Ensure that contracts align with organizational goals, compliance standards, and legal requirements.
- Maintain a centralized contract database to ensure all contracts are stored, tracked, and updated appropriately.
- Insurance Contract Management:
- Manage and oversee insurance contracts, ensuring timely renewals, renegotiations, and compliance with evolving regulations.
- Coordinate recredentialing processes with insurance companies, ensuring timely and accurate documentation submission.
- Assess and negotiate insurance contract terms to improve cost efficiencies and ensure appropriate coverage for healthcare services.
- Collaborate with internal departments to assess insurance needs and explore opportunities for better terms.
- Vendor & Business Contracts:
- Manage contracts related to business services and equipment, such as phone systems, printers, shredding, and other operational agreements.
- Negotiate competitive pricing and terms with vendors, ensuring cost-effectiveness while meeting operational needs.
- Collaborate with internal teams to assess needs and secure vendor agreements that align with organizational objectives.
- Renegotiation & Recredentialing:
- Oversee the renegotiation of existing contracts to achieve better terms, pricing, or service levels.
- Ensure the timely and accurate submission of documentation for insurance recredentialing, meeting all deadlines and industry standards.
- Maintain communication with insurance carriers to address recredentialing issues, updates, or questions.
- Compliance & Documentation:
- Ensure all contracts comply with applicable state and federal regulations, particularly those related to healthcare.
- Maintain accurate and organized records of contracts, amendments, and communications with external parties.
- Monitor industry trends and regulatory changes to provide recommendations on their potential impact on existing contracts.
- Collaboration & Communication:
- Work closely with legal, finance, and operational teams to ensure that contracts are aligned with business needs and financial strategies.
- Effectively communicate contract terms and relevant details with internal stakeholders to ensure compliance and understanding.
Qualifications:
- Education: Bachelor's degree in Business Administration, Healthcare Management, or a related field, or equivalent experience.
- Experience:
- Minimum of 3-5 years of experience in contract management, with at least 2 years in healthcare or a related field.
- Proven experience in managing insurance contracts, including recredentialing and renegotiating insurance terms.
- Experience negotiating and managing vendor contracts for office-related services and equipment.
- Skills:
- Strong negotiation and communication skills.
- Excellent organizational abilities, with an eye for detail and the capacity to handle multiple projects simultaneously.
- In-depth knowledge of healthcare regulations and insurance credentialing processes.
- Proficiency in contract management software and Microsoft Office Suite.
- Strong analytical skills and the ability to assess complex contracts and identify areas for improvement.
Work Environment:
- This position is based in an office environment.
This Contract Specialist role is essential for maintaining the smooth operation of American River Healthcare by ensuring effective contract management, recredentialing, and renegotiation. The successful candidate will contribute to the company's growth, efficiency, and compliance with industry standards.
