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Provider Services Contracts Coordinator - Temporary

Health Plan of San Mateo
South San Francisco, CA Temporary
POSTED ON 12/4/2024
AVAILABLE BEFORE 2/4/2025
The Provider Contract Coordinator maintains and manages our provider contracts data to ensure smooth operations and effective relationships with both non-contracted and contracted network providers. This role collaborates closely with various internal departments and external providers to facilitate accurate provider contracts and credentialing data.   Position overview Assist in the preparation, review, and execution of provider contracts, amendments, renewals, and Letter of Agreements. Work closely with Provider Network team to address provider inquiries, concerns, and contracting data-related issues. Assist in resolving contracting data-related disputes and conflicts, fostering positive relationships between the health plan and providers. Prepare reports and summaries related to provider contract data update, and provider network status. This includes changes received via mail, fax, electronic or any other sources. Coordinate with different departments to gather provider contract data and facilitate provider set up in our enterprise data systems. Facilitate and assist with provider reimbursement method as relate to contracting terms and conditions. Assist with Provider claims processing issues related to contracting but not limited to system configuration, provider directory, and provider credentialing processes. Review assigned documents and reports for accuracy. Maintain accuracy of the provider contracting data as related to network database and support other departments with necessary provider updates. Assists with special projects as needed to ensure provider contracting database is complete and accurate. Respond to inquiries and issues related to provider contracting data coming directly from providers and if escalation is needed, redirect providers to appropriate departments. Assist with administrative support which includes screening and researching incoming provider requests via multiples communication platforms.   Requirements These are the qualifications typically needed to succeed in this position. However, you don’t need to meet every requirement to apply.  Education and experience An associate’s degree or equivalent education, training or experience is required. Previous experience in healthcare contract coordination, provider relations, or a related role within a managed care setting. Detail-oriented with the ability to identify and rectify contract discrepancies. A minimum 2 years’ experience working in a health care setting or with health care data Project management experience or experience supporting program/ projects is preferred Experience working in a provider setting is a plus Knowledge of: Microsoft Office suites, knowledge of Excel (required) Process improvement principles (required) User experience design (preferred) Provider directories or provider network data(preferred) Ability to: Coordinate and research issues to assist with process improvement of data infrastructure to support higher-quality provider data Maintain knowledge of multiple provider databases. Translate business needs into specific data parameters to support analysis Perform multiple projects efficiently and with limited oversight, reprioritizing as appropriate Keep provider data sources up to date, processing provider data changes in a timely and accurate manner Establish and maintain cooperative working relationships across departments and with providers Communicate effectively, verbally and in writing   Salary and benefits The starting salary range is $25.03 - $31.66 per hour, depending on the candidate’s work experience. Excellent benefits package includes: HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums) Fully paid life, AD&D and LTD insurance Retirement plan (HPSM contributes equivalent of 10% of annual compensation) 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year Tuition reimbursement plan Employee wellness program It is HPSM's policy to provide equal employment opportunity for all applicants and employees.  HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law.  HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.

Salary : $25 - $32

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