Provider Contract Administrator

Role Overview

• 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.