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Carrot Peelers, Sales, Personality and Your Job Search
Public Interest
Legal Staff
Corporate - Contract Law
Min 5 yrs required
Provider Contracting Administrator Duties: Responsible for the implementation, completion and tracking of all notices to meet regulatory and contract requirements related to services and assist with grievances and appeals notices. Responsible for screening new ancillary and professional contract requests. Initiate out of network providers to pursue contracting where needed to ensure network adequacy. Ensure proper execution of contracts by internal and external signing authorities. Review and revise agreements and templates as necessary for compliance with regulatory and internal requirements. Draft amendments as required by the VP of Contract & Network Management. Negotiate rates and contract terms within the Provider Contracting Administrator’s level of authority. Assist with contracting related projects as directed. Provide contract analysis and summaries as needed to ensure compliance with both NYS regulatory policy and iCircle business targets and interests. Assisting with cross functional projects to provide research and analysis of the provider network. Perform all other duties relevant to the position as assigned by supervisor.
Qualification and Experience
Qualifications: Associate’s degree in Paralegal studies, Health Care Administration, Business, Finance, or other appropriate field required, Bachelor’s degree preferred. 5 years’ experience as a paralegal or contract administrator in health care required, preferably in a managed care environment. Skills to: Adhere to all CDS Life Transitions, Inc. policies and procedures. Adhere to the Agency Mission, Vision, Shared Values, and Customer Service Standards. Attend mandatory education and training modules as scheduled; obtain and maintain required certifications. Maintain all required certifications/training by State regulations and CDS policy. Act as a professional representative of CDS Life Transitions, Inc. in regard to appearance, behavior, temperament, communication, language, and dress. Demonstrated knowledge and understanding of healthcare industry, legal and regulatory requirements. Working and practical knowledge of standard health insurance reimbursement mechanisms Basic computer skills Ability to work independently and motivate others. Ability to communicate effectively, both orally and in writing.
Requisition ID : 2482
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