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Hours:

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On-Call Required:

Hourly Pay Range (Minimum - Midpoint - Maximum):

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

Please Note: As part of our recruitment process, you may receive communication from Dawn, our virtual recruiting assistant. Dawn helps coordinate scheduling for screening calls and interviews to ensure a smooth and timely experience. Rest assured, all candidate evaluations and hiring decisions are made by our recruitment and hiring teams.

What You Will Do
The Contracts Associate assists with the operations, negotiations and analyses of contracts, capitations and ongoing relationships with providers. Oversees the administration and production of provider contracts by negotiating Letters of Agreement with non-contracted providers; auditing IDX claims system to verify appropriate and correct reimbursement; liaison with claims support department on new contracts and contract changes. Participates in SCMG strategy and support through contract and claims data analysis. Responsible for operational support system response to contract informational needs and monitor physician issues regarding contracting priorities.

Required Qualifications

• 4 Years experience in Managed Care contracting.
• Experience in a health related or contract negotiation environment.
• Experience in maintaining positive working relationships with Physician and Provider representatives.
• Must have experience with analyzing, interpreting data, and preparing reports.

Other Qualification Requirements

• Associate's degree in Accounting, Finance, Business Administration, Health Care Administration; experience may substitute for education. - Required

Essential Functions

• Contract administration
  Responsible for requesting, preparing and analyzing data necessary for contract negotiations. Develop reports necessary to determine contract performance compared to budget and established standards.
  Conducts and participates in the successful completion of assigned contract negotiations as they relate to SCMG contracts.
  Assist in the development and maintenance of communication links throughout the system to identify reimbursement issues and participation in the development of action items for resolution. In addition, communicate current contract information.
  Assures contract information is communicated and coordinated to appropriate internal departments and audit is performed to ensure accurate contract claim/encounter pricing and other reimbursement terms. Work in conjunction with system representatives in the implementation of the IDX Contract Adjudication system.
  Assists with other duties as assigned, to be completed in an agreed upon format in an agreed upon time frame.
  Demonstrates teamwork by participating in achieving department goals. Shows willingness to help out with any task to ensure the success of the department. Works in a spirit of cooperation with all Sharp employees.
• Quality and customer service
  Provide operational support to internal and external customers.
  Assist in project coordination with SCMG departments: Claims, Utilization Management, Provider Services, and Pharmacy Benefits Department.
  Maintains service orientation to representatives of SCMG through consistent assessment of needs and timely response to requests.
  Develops and maintains relationships with Physician and Provider contract representatives in support of the SCMG Mission, Values, and Philosophy and ensure timely response to contractual issues and contract compliance problems.
  Collaborates with other entities/departments to resolve identified issues with demonstrated improvement in operational flow.
  Demonstrates resolution of operational issues with targeted outcomes as negotiated with the Director.
• Regulatory compliance
  Maintains work place in safe condition. Assure appropriate chair height, keyboard and screen placement, securing electrical wiring, observing departmental safety policies and procedures. Reports safety hazards within 1-3 days from time problem first identified.

Knowledge, Skills, and Abilities

• Knowledge of Managed Care and Managed Care Contracts, experience in PC computer utilization for word processing and Excel spreadsheet analysis, and managerial skills is required.
• Working knowledge of Managed Care capitation, RBPVS/CPT/ICD-10 coding.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class