Contract Specialist (Healthcare Provider Contracting) - Multiple Roles (Onsite - Columbus, Ohio)
We are looking to hire multiple candidates with the below skill sets mentioned and experience for one of our major clients within the Health Insurance industry. This is a fully onsite position for the first 90 days, in Columbus, Ohio. This is a 2-years contracting opportunity with the potential for permanent employment. Interested candidates may share their updated resumes with Carolina – OMG Technologies.
These positions will start as fully on-site at 3000 Corporate Exchange, Columbus, Ohio for the first 90 days and then they are expected to transition home once candidates pass their 90 days. Therefore, candidates MUST be local to Columbus, OH. Schedule requirements will be M-F, 8am-5pm EST.
Candidates will be required to provide their own equipment and have access to reliable internet after the 90 days training period. During training, equipment will be provided onsite. Candidates will be supporting one of the following health plans based on business needs: Nebraska, Indiana, Iowa, or Nebraska Health Plan.
- Negotiates assigned contracts and letters of agreement with hospitals, physician groups, and ancillary providers that result in high-quality, cost-effective, and marketable providers.
- Maintains tracking system and publish reports according to departmental procedures.
- Initiates, negotiates, generates, and tracks provider Letters of Agreement, contracts, and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments.
- Supports network development throughout the state including researching, recruiting, and negotiating with providers.
- Participates in the evaluation of the provider network and implementation of strategic plans to meet Molina’s network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physicians, hospitals, and ancillary providers.
- Assists in the analysis and coordination of amendments, reimbursement, and language changes.
- Requests information on billing codes, services provided, and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Travels regularly throughout designated regions to meet targeted needs.
- 0-2 years of provider contract negotiation experience in the health care field including, but not limited to, provider’s office, managed care organization, or other health care field.
- Candidates MUST have provider contracting experience and phone experience.
- Knowledge of Excel, Word, Outlook, and PowerPoint programs.
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
- Bachelor’s Degree or equivalent work experience in the health care field including, but not limited to, provider’s office, managed care, or other health care field.
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers.
Other Preferred Skills/Education:
- Ability to interact well with all internal and external customers.
- Ability to work and make decisions independently.
- Excellent organizational and verbal and written communication skills.
- Ability to abide by Molina’s policies.
- Ability to maintain attendance to support the required quality and quantity of work.
Other job specifications:
- Employment Type: Contract to Hire (CTH), W2 only. NO C2C.
- Contracting Period: 2 years contract with potential for permanent employment.
- Job Location: Fully on-site at 3000 Corporate Exchange, Columbus, Ohio for the first 90 days. The candidates will be expected to transition home once they pass their 90 days. Therefore, candidates MUST be local to Columbus, OH. Schedule requirements will be M-F, 8am-5pm EST.
- Contract Rate/Salary: $27/hr. on W2.
- Interview Process: Phone/WebEx
Interested candidates may share their updated resumes with Carolina – OMG Technologies.