Contracting Coordinator - San Jose, United States - Santa Clara Family Health Plan

Description

Contracting Coordinator

Salary Range: $69,937 - $104,906
The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change.

FLSA Status:Non-Exempt
Department:Provider Network Management
Reports To:Director, Provider Network Management

Employee Unit:Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521

GENERAL DESCRIPTION OF POSITION

The Contracting Coordinator performs important activities related to contracting with SCFHP's provider networks, in accordance with state and federal regulatory standards and guidelines, and SCFHP policies and procedures, and business requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES

To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.

1. Thoroughly understand the various contract templates and be able to customize the appropriate template based on the specific situation.
2. Using SCFHP templates, draft, negotiate, and process contracts, amendments, termination notices and Letters of Agreement as requested, in accordance with state and federal requirements, and organized in a manner that adheres to SCFHP standards for management approval.
3. Work cooperatively with the Manager, Contracting and Credentialing and the Director, Provider Network Management, and other members of the team to execute SCFHP contracting efforts.
4. Perform all necessary tasks related to producing and delivering contract documents and monitor the status of these documents in the contracting process.
5. Use contract management software to appropriately store contract documents and create a tickler system for managing contract status (i.e. effective, renewal and termination dates).
6. Provide support to the contracting committee including, but not limited to organizing and scheduling committee and other meetings to support contracting activities, managing agendas, track actionable items, and communication with stakeholders.
7. Assist the Provider Network Management Department in researching, developing, and drafting communications, resources and tools necessary to manage the SCFHP provider network. This may include regulatory guidance, updates to the provider manual, SCFHP website, SCFHP provider portal and ad hoc provider communications.
8. Draft internal and external documents/correspondence related to contracting processes such as desktop resources, procedures, flow charts, audit tools, reports, and logs for management approval. Implement identified activities in order to demonstrate efforts to remain in compliance with state and federal requirements and SCFHP policies and procedures and business requirements.
9. Execute internal activities related to onboarding or terminating providers, coordinating with other departments as necessary.
10. Work in collaboration within the department and across other departments on ad hoc, regulatory, and special projects.
11. Perform other duties as required or assigned.

REQUIREMENTS - Required (R) Desired (D)

The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.

1. Bachelor's Degree in Healthcare Administration, Business, Social Sciences or a related field; or equivalent experience, training, or coursework. (R)
2. Minimum two years of experience in managed care or in a healthcare setting in positions requiring routine interaction with internal and external stakeholders, one year of which was in a role involving significant exposure to provider network management contracting activities. (R)
3. Ability to understand and stay current on contracting guidelines, regulations, and resources, and apply requirements to related tasks, audits, tools, and methodology. (R)
4. Excellent oral and written communication skills including the ability to express oneself clearly and concisely when interacting with SCFHP internal departments, members, providers, and outside entities over the telephone, in person or in writing. The ability to draft professional correspondence, training materials, and other related resources. (R)
5. General knowledge of Health Plan contracting processes and requirements. (R)
6. Proficient in adapting to changing situations and efficiently alternating focus between tasks to support the department's operations as dictated by business needs. (R)
7. Efficiently operate all applicable computer software including Microsoft computer applications Outlook, Word, Excel, PowerPoint and contracting software. (R)
8. Ability to use a keyboard with moderate speed and a high level of accuracy. (R)
9. Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)
10. Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position.(R)
11. Maintain confidentiality. (R)
12. Comply with all SCFHP policies and procedures. (R)
13. Perform the job safely and with respect to others, to property and to individual safety. (R)

WORKING CONDITIONS

Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.

PHYSICAL REQUIREMENTS

Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation:

1. Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R)
2. Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R)
3. Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R)
4. Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R)
5. Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R)
6. Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R)

ENVIRONMENTAL CONDITIONS

General office conditions. May be exposed to moderate noise levels.

EOE