Contract Specialist I

Job Title: Contract Specialist I
Duration: 3 Months (Possible extension)
Location: Remote

CANDIDATES MUST LIVE IN ONE OF THE PREFFERED 15 STATES ((Client, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle), WI, AZ)

Job Description:
Will these role be fully remote? Yes
What is the expected schedule: (include days/times/timezone) 8am-5pm CST
What are the day to day job duties:  Day-to-day responsibilities include negotiating assigned contracts and Letters of Agreement with hospitals, physician groups, and ancillary providers to support a high-quality, cost-effective, and competitive provider network.
The role maintains detailed tracking systems and produces reports in alignment with departmental procedures, ensuring transparency, accuracy, and accountability across all contracting activities.
Core functions include initiating, negotiating, generating, and tracking provider Letters of Agreement, contracts, amendments, and Single Case Agreements from initial draft through full execution using approved standardized templates and contractual frameworks.
This position plays a critical role in supporting SB1264 case resolution efforts, including direct participation in negotiation strategy, settlement positioning, and coordination related to arbitration, mediation, and disputed out-of-network claims.
The role actively supports statewide network development through targeted research, recruitment, and negotiation with providers while ensuring alignment with Client’s network adequacy standards and regulatory requirements.
It contributes to the evaluation and implementation of strategic network plans to maintain compliance and optimize access.

Responsibilities also include clear and professional communication of contract terms, payment structures, reimbursement methodologies, and SB1264 settlement positions to hospitals, physicians, and ancillary providers.

The role assists with the analysis and coordination of amendments, reimbursement modifications, and contract language updates, ensuring accuracy and consistency across all provider agreements.
Additionally, this position gathers and validates billing codes, service details, and supporting documentation required to complete comprehensive contract profiles and SB1264 case files.
It coordinates the preparation, routing, and distribution of all contracting documentation to ensure timely execution and adherence to standardized operational processes, directly supporting negotiation efficiency and regulatory compliance.

Top Skills Required:
Knowledge in Excel, Word, Outlook, and PowerPoint programs 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 Client’s policies
Ability to maintain attendance to support required quality and quantity of work Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

Required Education/Certification(s):
Bachelor’s Degree or equivalent work experience in health care field including, but not limited to, provider’s office, managed care, or other health care field.

Required Years of Experience:
1-2 years 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.

• Is there potential for these to extend past 3 months or convert to full-time positions with Client? Yes

Summary:
Negotiates assigned contracts and letters of agreements 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.

Essential Functions:
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 state to including researching, recruiting and negotiating with providers.
Participates in the evaluation of provider network and implementation of strategic plans to meet Clients network adequacy standards. Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. Assists in analysis and coordination of amendments, reimbursement, and language changes.
Requests information of 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. Knowledge/Skills/Abilities:
Knowledge in Excel, Word, Outlook, and PowerPoint programs
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 Clients policies Ability to maintain attendance to support required quality and quantity of work Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

Required Education:
Bachelors Degree or equivalent work experience in health care field including, but not limited to, providers office, managed care, or other health care field.

Required Experience:
0-2 years provider contract negotiation experience in the health care field including, but not limited to, providers office, managed care organization, or other health care field