What are the responsibilities and job description for the Contract Specialist position at AMERINC?
Your career starts now. We’re looking for the next generation of healthcare leaders.
At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
About this job:
The Contract Specialist plays a key role in fostering positive relationships between the team, the plan, and other stakeholders. They ensure that contract data and documents are accurately represented in all operating systems. Additionally, they act as a proactive contract administrator, addressing and resolving any issues related to the loading of contracts.
Responsibilities:
- Build and maintain positive relationships with the team, Plan, and stakeholders.
- Ensure contract data and documents are accurately represented in operating systems.
- Act as a proactive contract administrator, resolving contract administration issues.
- Audit contract documents and provider records for accuracy.
- Manage and monitor Excel reports for projects and assignments.
- Align and create contract records in the contract management system with 95% accuracy.
- Monitor electronic contract files and ensure compliance with policies.
- Escalate requests that contradict business processes or contract language.
- Support various departments in investigating provider data and credentialing.
- Research and resolve conflicting data and documents.
- Identify and report compliance issues.
- Maintain knowledge of Facets or other claims systems and relay contract corrections.
- Communicate effectively and professionally with all parties.
- Collaborate with departments to execute AmeriHealth and Plan strategies.
- Perform administrative duties and attend required training sessions.
- Stay updated on AmeriHealth, Plan regulations, policies, and procedures.
Education & Qualifications:
- High School/GED required; bachelor’s degree preferred.
- 1 to 2 years experience in provider network management, finance operations, contract management, or contract administration in a healthcare or Managed Care organization.
- Experience with contracting software (e.g., Portico, McKesson, Conga, Salesforce).
- 1 to 2 years of Medicaid experience is required.
- Business analyst and project management experience preferred.
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.
