Provider Contract Specialist

Shift: Monday - Friday
Location: Must reside 30-45 miles from St. Louis, MO
Hybrid: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. Alternate locations may be considered if candidates reside within a commuting distance from an office.

About the role

The Provider Contract Specialist will coordinate the process for new and existing providers joining the network, including creating standard contracts for providers as needed.

Responsibilities

• Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery systems
• Prepare the information for timely and accurate submission to the Provider Data Management area
• Ensure updates/changes for existing network providers are interpreted and loaded accurately
• Ensure accurate and timely loading of professional and facility contracts across value-based and fee-for-service agreements for provider solutions
• Work directly with contracting directors and managers to understand what is negotiated and how the negotiated agreement is translated into the company's systems, resulting in accurate and timely loading
• Perform internal audit of provider records, ensuring accuracy against rosters
• Serve as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround
• Serve as local market expert supporting (and managing when necessary) the provider onboarding process and provider updates submitted by provider offices within defined market

Requirements

• Requires a H.S. diploma or equivalent and a minimum of 2 years experience with provider contracts, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background

Skills

• Strong organizational and time management skills
• 1-3 years experience in a Health Care role
• Strong communication skills
• Proficiency in MS Excel

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical, dental, and vision benefits
• Short and long-term disability benefits
• 401(k) with company match
• Stock purchase plan
• Life insurance
• Wellness programs and financial education resources

Elevance Health operates in a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.