Contract Specialist: Managed Care Contracting

Primary Duties and Responsibilities

Maintains the Hoag Network contracting process for the Managed Care Contracting Department.

Distributes all new and amended PPO/HMO/Ancillary agreements to internal/external stakeholders as applicable.

Responsible for the ongoing maintenance and testing of Hoag Network contracts in EPIC.

Responsible for ongoing audits of contract reimbursement terms working with payors to address all reimbursement issues.

Maintains contract files and online access to contracts and various databases, coordinates flow of contract documents for signature throughout the organization, communicates Contract Information to internal and external customers, provides administrative assistance if needed.

Qualifications

• Education and Experience
• High School diploma and three years experience in an office setting, preferably in health care or managed care.
• Understanding of health insurance plans (HMO, PPO, etc.)
• Two years of college preferred
• License Required
• N/A License Preferred
• N/A Certifications Required
• N/A Certifications Preferred
• N/A