Provider Contract Administrator
Premera Blue Cross
full-time
Posted on:
Location Type: Remote
Location: Alaska • Arizona • United States
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Salary
💰 $58,600 - $93,800 per year
About the role
- Manage the contract library by uploading and configuring XML contract templates with appropriate variables and alternate terms for use by employees creating provider specific contracts.
- Test contract templates, troubleshoot issues, partner with the system vendor as needed, and define a schedule for library maintenance.
- Create and implement efficiencies with Contract Library.
- Communicate all contract library changes and updates to all users.
- Interpret contract requests from Network Management for the development, issue, execution, and activation, ensuring compliance of provider contracts for complex provider groups and facilities.
- Manage timelines and deliverables for contracts and OIC filings.
- Support implementation of new provider networks including participation in cross-departmental implementation work groups.
- Research, analyze and provide interpretation on complex and abstract contracting issues.
- Collaborate with other Premera/LifeWise departments to ensure that benefit and administrative provisions for assigned contracts are consistent with contractual intent and regulatory requirements and have appropriate approvals.
- Complete required state regulatory filings for assigned contracts.
- Serve as the primary resource in resolution of regulator issues and inquiries related to those filings.
- Identify and resolve contract and compliance issues relating to implementation of customized contracts.
- Develop and maintain strong positive collaborative relationships with partner departments.
- Lead and/or participate in cross-departmental work groups as required in carrying out new network, product, benefit, policy implementation functions and process improvements.
- Train and mentor Contract Specialists.
Requirements
- High school diploma or GED. (Required)
- Four (4) years of experience to include: (Required)
- Three (3) years of experience contract processing, and/or technical writing with legal/regulatory research.
- Two (2) years of experience researching health plan regulatory requirements, such as HIPAA, COBRA, and state insurance requirements.
- Strong Microsoft Office skills. (Preferred)
- Experience with XML. (Preferred)
- College degree in related field. (Preferred)
- Demonstrated training/auditing skills. (Preferred)
- Four (4) years of experience in the healthcare insurance field including medical terminology knowledge. (Preferred)
Benefits
- Medical, vision, and dental coverage with low employee premiums.
- Voluntary benefit offerings, including pet insurance for paw parents.
- Life and disability insurance.
- Retirement programs, including a 401K employer match and a pension plan that is vested after 3 years of service.
- Wellness incentives with mental well-being resources, including counseling services and mindfulness programs.
- Generous paid time off.
- Tuition assistance for continuing education.
- Employee recognition program to celebrate anniversaries and team accomplishments.
- Commuter perks to lessen environmental impact and save costs.
- Free on-site parking.
- Subsidized on-campus cafes.
- On-campus fitness & well-being center.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract processingtechnical writinglegal researchregulatory researchhealth plan regulatory requirementsXMLmedical terminology
Soft Skills
communicationcollaborationproblem-solvingtrainingmentoringrelationship building
Certifications
high school diplomaGED