JOB SUMMARY

The Contracting Operations Specialist supports the day-to-day administration and operational management of healthcare contracts throughout the contract lifecycle. This position coordinates contract intake, review, execution, renewals, amendments, and terminations; maintains accurate contract records and data across multiple systems; and monitors key contractual dates, requirements, and deliverables.

The Contracting Operations Specialist works collaboratively with Contracting, Credentialing, Revenue Cycle, Compliance, Legal, Finance, and clinical operations to support accurate implementation and administration of provider, payer, and/or vendor agreements. The position also supports regulatory and audit readiness, reporting, process improvement, and the development and maintenance of contracting procedures and documentation.

MINIMUM & PREFERRED QUALIFICATIONS

Education/Training

Minimum: High school diploma or equivalent.

Preferred: Associate’s or Bachelor’s degree in Business Administration, Healthcare Administration, Health Services, Finance, Contract Management, or a related field.

Experience 

Minimum: 3+ years of progressively responsible administrative or operational experience in healthcare contracting, provider relations, managed care, credentialing, healthcare operations, contract administration, or a closely related area, including experience maintaining detailed records, coordinating workflows, and working with data across multiple systems.

Preferred: 4+ years of healthcare contracting or managed care experience, including experience with provider and/or payer contracts, contract lifecycle management, amendments and renewals, contract implementation, healthcare reimbursement or rate data, audit/compliance support, and contract management or related healthcare information systems.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Skills, Knowledge & Abilities

· Working knowledge of healthcare contracting and contract administration principles, practices, and terminology.

· Knowledge of managed care operations, provider networks, payer/provider relationships, and healthcare reimbursement concepts.

· General knowledge of applicable healthcare regulatory, accreditation, and payer requirements, including CMS, DMHC, NCQA, and health plan requirements, as applicable.

· Ability to review and interpret contract provisions, rates, effective dates, renewal provisions, amendments, and other contractual requirements.

· Ability to maintain accurate contract records and ensure consistency and integrity of data across multiple systems.

· Strong analytical, organizational, problem-solving, and critical-thinking skills.

· Ability to track multiple contracts, deadlines, deliverables, renewals, and competing priorities simultaneously.

· Ability to develop and maintain reports, dashboards, tracking tools, standard operating procedures, templates, and other operational documentation.

· Strong attention to detail and demonstrated ability to identify discrepancies and resolve data or documentation issues.

· Ability to effectively coordinate work across multiple departments and communicate contract requirements to internal stakeholders.

· Ability to exercise sound judgment, maintain confidentiality, and appropriately handle sensitive and proprietary information.

· Strong written and verbal communication and interpersonal skills.

· Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and Teams; experience with contract management, credentialing, claims, provider data, or other healthcare information systems preferred.

· Ability to work independently as well as collaboratively in a team-oriented environment.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical demands described here are represented of those that must be met by an employee to successfully perform the essential functions of this job. This position primarily involves sedentary work with routine use of a computer and standard office equipment. The role may require occasional light physical activity (up to 10 pounds) and brief periods of bending, reaching, or filing. The employee must be able to maintain concentration for extended periods, analyze detailed information, and meet deadlines, with or without reasonable accommodation.

PAY RANGE

$33.00 - $36.00 / hourly