Job Details

Position Purpose:
Assist with the contract preparation, contract submission process, auditing of provider information systems (AMISYS), and tracking provider compliance.

Education/Experience:
High school diploma or equivalent. 2+ years of experience, preferably in the healthcare or insurance industry, including experience managing large databases and experience with provider information systems. Auditing experience preferred.

Maintain spreadsheets and collect, track, prepare, compile, and distribute statistical data for daily and monthly reports.

Maintain and report on the company's compliance with contract submission rules and exception requests and communicate to Manager on a monthly basis.

Support the contract submission process to ensure confirmation with Corporate standards, provide support to the Contract Conferences and ensure that appropriate internal controls are established to account for and secure hardcopy or scanned images of contracts.

Maintain and update on a routine basis the contract databases.

Produce reports.

Coordinate the Corporate wide data verification process for contracted providers.

Track and monitor provider compliance with contract deliverables.

Interface with the credentialing staff to ensure all data systems are congruent.
Performs other duties as assigned

Complies with all policies and standards

EEO:

"Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."

Position Purpose:
ssist with the contract preparation, contract submission process, auditing of provider information systems (AMISYS), and tracking provider compliance.

Education/Experience:
High school diploma or equivalent. 2+ years of experience, preferably in the healthcare or insurance industry, including experience managing large databases and experience with provider information systems. Auditing experience preferred.

Maintain spreadsheets and collect, track, prepare, compile, and distribute statistical data for daily and monthly reports.

Maintain and report on the company's compliance with contract submission rules and exception requests and communicate to Manager on a monthly basis.

Support the contract submission process to ensure confirmation with Corporate standards, provide support to the Contract Conferences and ensure that appropriate internal controls are established to account for and secure hardcopy or scanned images of contracts.

Maintain and update on a routine basis the contract databases.

Produce reports.

Coordinate the Corporate wide data verification process for contracted providers.

Track and monitor provider compliance with contract deliverables.

Interface with the credentialing staff to ensure all data systems are congruent.
Performs other duties as assigned

Complies with all policies and standards Story Behind the Need

• What is the purpose of this team?
• Describe the surrounding team (team culture, work environment, etc.) & key projects.
• Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?

• Contracting & Network Development
• Supportive
• Contract coordinators - key projects are submitting provider load forms (PLF)
• To load providers via PLFs
• Backfill contingent position
• Need enough team members to handle workload
• Not at this moment

Typical Day in the Role

• Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
• What are performance expectations/metrics?
• What makes this role unique?

• Process Salesforce cases submitted to load new contracts, contract amendments, provider adds, changes, terms, etc.
• Process non-delegated rosters received from Contract groups.
• Support the contract submission process to ensure confirmation with corporate standards by the health plan(s).
• Verify provider information via Cactus and Portico to ensure all Health Plan data systems are congruent regarding credentialing.
• Work with configuration and credentialing to answer any questions about contract changes or provider changes.
• Support the Prospective inbox and NetDev inbox.

Candidate Requirements Education/Certification Required: HSD or equivalent Preferred: n/ Licensure Required: n/ Preferred: n/ Years of experience required:
1+ years of contracting, provider data management, credentialing or related experience.
Intermediate skills with MS word and excel.

Disqualifiers:
HM is NOT looking for someone who has worked in customer service

dditional qualities to look for:
Healthcare experience and experience with provider information or salesforce preferred.