Health Plan Contract Specialist - Military Veterans

Description

Salary Estimate: $79248.00 - $118892.80 / year
Learn more about the benefits offered for this job.

The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

Introduction

This position will be based in Campbell, California in the Greater San Jose Area and require that candidates be local to the area.

Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Contract Specialist opening with HCA Healthcare today and find out what it truly means to be a part of the HCA Healthcare team.

Benefits

At HCA Healthcare, we want to ensure your needs are met. We offer eligible colleagues an attractive benefit package that includes medical, wellbeing, dental and vision benefits along with some unique benefits including:

• Medical, Dental, Vision, Life Insurance and Flexible Spending
• Paid Time Off (PTO) and Personal Leave
• 401K(100% annual match - 3% to 9% of pay based on years of service)
• Academic Assistance and Reimbursements for Tuition and Student Loans
• Employee Discounts including Tickets, Retail, Mental Health Apps, Education Apps, Identity Theft Protection etc.
• Home, Auto, and Pet Insurance
• Employee Stock Purchase Program (ESPP)
• Short Term & Long Term Disability coverage
• Adoption Assistance
• Legal Benefits and lots more!

Learn more about Employee Benefits

We are seeking a(an) Contract Specialist for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply!

Job Summary and Qualifications

Seeking a Health Plan Contract Specialist to provide expertise for the interpretation and documentation of the contract terms in our operating/payment system. This role serves as a liaison between the MSO Operations and Data Management Department.

We are located in the heart of Silicon Valley in Campbell, CA.

In this role, you will:

• Research complex contractual documents for interpretative purposes and for answering questions for other departments
• Understand and communicate contract clauses dealing with payments terms
• Support administrative function including documenting contract terms
• Follow-up on requests for adds, changes, deletes, and credentialing information
• Provide support for the generation of contract documents for all ancillary providers
• Serve as a liaison in reviewing claims errors and the interpretations that are part of the contract entry process
• Communicate with external and internal audiences to understand the intent of contracts and ensure the end results are achieved

You should have:

• Must have health plan contract experience in the Managed Service industry
• Bachelor’s degree is required
• Possesses a strategic vision of healthcare payment contracts in the operation and payments system perspective
• 3+ years of heath care claims processing experience
• 1+ year of provider operations and contract experience
• 2+ years of experience communicating contract terms and contract rate methodology
• Able to exercise good judgment in problem solving and decision-making situations

Pacific Partners Management Services (PPMSI) is a management services organization formed in 1997. We provide services to IPAs, supporting over 1,000 independent physicians in California. Our services include executive management, financial services, utilization management, quality management, credentialing, contracting, claims processing, provider relations, and member services. We are a part of HCA Healthcare’s Physician Services Group (PSG) and located in the heart of the Silicon Valley in Campbell, CA.

Physician Services Group is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare’s graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.

HCA Healthcare has been named one of the World's Most Ethical Companies by Ethisphere Institute for over a decade.  In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Across HCA Healthcare’s more than 2,000 sites of care, our nurses and colleagues have a positive impact on patients, communities and healthcare.
Together, we uplift and elevate our purpose to give people a healthier tomorrow."- Jane Englebright, PhD, RN CENP, FAAN
Senior Vice President and Chief Nursing Executive

If you find this opportunity compelling, we encourage you to apply for our Contract Specialist opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing apply today!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.