JSG is seeking a Healthcare Plan Contracts Specialist for a 6 month onsite consulting opportunity in Orange County, CA.
Onsite 6 Month Contract
Pay $35.00 - $45 per hour
Responsibilities
- Evaluate out of network requests from medical management, assess in-network providers for redirection and attend daily staff meetings to discuss outcomes.
- Negotiate single patient agreements for members directed out of network and serve as a point of contact for provider inquiries.
- Assist Contracts Managers with contract creation, distribution and collection of outstanding contract documents.
- Maintain select electronic library of provider contacts and contracts on shared drive and contract management system / database.
- Respond to inquiries regarding contract status, network rosters, provider reimbursement and application / credentialing status in a timely manner.
Minimum Qualifications
Associate degree PLUS 2 years of work experience related to managed care or related field required; an equivalent combination of education and experience sufficient to successfully perform the essential duties.Preferred
Experience negotiating single patient agreements, professional and ancillary contracts.Experience with elementary data analysis.JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more.
Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.
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