Associate Contract Specialist Jobs

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

The Associate Contract Specialist is responsible for coordinating the contractual and operational implementation and ongoing maintenance of Ancillary Health provider or vendor contracts for products across all lines of business. This individual monitors compliance with contractual agreements, assists with communication of Point32Health policies, procedures, and new initiatives to network providers, and spearheads efforts to resolve operational issues.

Key Responsibilities/Duties – What You Will Be Doing

• Coordinate information collection and dissemination for new and established network providers, including signed contracts and amendments and appropriate provider database entries and contract implementation processes.
• Participate in cross-functional meetings as required; initiate and participate in department projects as necessary.
• Establish and maintain protocols to monitor compliance with contractual agreements.
• Serve as an active resource for partner departments and network providers regarding the operational aspects of contract arrangements.
• Support contract development efforts for both new and existing providers.
• Coordinate all activities related to contract implementation.
• Other duties and projects as assigned.

Work with department resources to ensure that issues are clearly articulated, documented and prioritized. Communicate estimated turn around times to providers and facilitate resolution internally.

Facilitate communication with the provider network by providing clarification, interpretation and guidance regarding THP policies, procedures and new initiatives.

Participate in cross-functional meetings as required; initiate and participate in department projects as necessary.

Perform other duties as needed (e.g. mailings, filing, departmental projects, etc.)

Qualifications – What You Need To Perform The Job

EDUCATION, CERTIFICATION AND LICENSURE:

• The position requires a Bachelor’s Degree or equivalent experience.

EXPERIENCE (minimum Years Required)

• 3-5 years work experience, preferred experience in managed care or other health care environment with knowledge of health care market and needs/concerns of health care
• Experience and familiarity with provider agreements and contracts is preferred.

Skill Requirements

• Possess strong customer focus and expertise in setting and managing customer expectations.
• Requires the ability to learn and apply Point32Health Plan’s policies consistently and seek guidance when necessary.
• Requires the ability to understand and interpret the various aspects of a contract: financial, legal, and operational with emphasis on implementation of contract terms.
• Requires initiative, sound judgment, and the ability to work independently under pressure in a constantly changing environment balancing multiple priorities.
• Requires excellent diplomacy, oral and written communication skills as well as the ability to coordinate efforts among various departments at Point32Health
• Must be able to work cooperatively as a team member.
• Excellent interpersonal skills are necessary to develop strong working relationships with internal and external contacts.
• Must be highly motivated individual with excellent organizational skills to manage large volumes of information and multiple assignments; attention to detail is key.
• Must be able to conceptualize and envision the impact of change and seek out efficiencies at work. Must be flexible and a proponent/champion of change.
• Requires the ability to understand the nuances of the various product lines and the unique operational and financial features associated with each product.

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel):

• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• Must be able to work under normal office conditions and work from home as required.
• May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.