Supervisor, Provider Contracting Specialists

The Provider Contracting Operations Supervisor will be responsible for overseeing the reviewing and delivery process of onboarding provider data to ensure integrity and accuracy.

Maintain contract templates and other documents to ensure compliance upon completion, create and manage policies & procedures, and coordinate with other business units to ensure cohesion.

Manage CMS and Medicaid opt-out and exclusion processes.

To perform this job successfully, an individual must be able to perform the job description satisfactorily. This job description reflects management's assignment of essential functions;

it does not prescribe or restrict the tasks that may be assigned. The requirements listed below are representative of the knowledge, skill, and ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Excellent verbal and written communication skills.

Detail oriented and analytical.

Strong organizational skills.

Ability to manage multi-level and complex organizational structures.

Managed Care operations and regulatory requirements for all lines of business.

FFS and Capitation contractual arrangements with Primary Care and Specialist providers.

Solid understanding of provider contracting processes.

Detail knowledge of systems utilized for provider contracting operations.

Detail knowledge of Commercial, Medicare, and Medicaid program guidelines.

Possess working knowledge of provider contracts and / or regional application of contracting methodologies.

Must have the ability to analyze and process all types of contract documents and templates accurately utilizing advanced level knowledge of regulations.

Must possess the ability to effectively present information and respond to questions from managers, employees, customers

Must possess advanced reasoning and problem-solving abilities and planning skills.

Ability to multi-task, prioritize, and work in a fast-paced environment under minimal supervision.

Proficient in Excel including the ability to create and revise Excel spreadsheets to provide accurate and clear reports.

Requires a dynamic person with the ability to work in a fast-paced environment

Requires the ability to accept feedback and implement changes effectively

Requires ability to coach staff, to influence colleagues in a positive, effective manner

Excellent relationship-building skills and embodying Prospect cultural values

Excellent written / verbal and organizational skills are required.

Must be proficient in Excel and Word skills.

Preferred proficiency in Evips / Payer 5 systems or similar

Must be self-motivated and possess the ability to complete tasks independently within established timeframes.

This role is 100% remote.

Required Education / Experience

Bachelor’s degree or five years of relevant experience.

Contract administration in a managed care environment.

3 years of experience entering data in a provider data platform.

2 years of experience leading / training staff directly or indirectly.

Preferred Education / Experience

Bachelor’s degree in Business Administration or similar field of study.

3 years of experience in managing staff.