Contract Specialist

Remote Jobs; United States; Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare services company is seeking a dedicated professional to engage with benefit plan members and monitor health claims. This role requires a high school diploma and substantial experience in a healthcare or customer service setting. The ideal candidate will excel in communication and possess strong analytical skills to drive member engagement and enhance service delivery.

Qualifications

• 5+ years experience in healthcare or customer service roles.
• Ability to navigate and utilize various healthcare platforms.
• Strong documentation and reporting skills.

Responsibilities

• Identify and engage benefit plan members regarding network steerage.
• Monitor health benefit claims for utilization trends.
• Conduct outreach to new benefit enrollees.

Skills

Documentation

Communication

Interpersonal

Data Analysis

Education

High School Diploma or GED

Tools

Innovaccer

EPIC

ACO MS

Meditract

KHIE

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Engage in meaningful work that promotes community health and member well-being
- Supportive and collaborative work environment
- Chance to make a positive impact on member engagement and network utilization
- Involvement in strategic projects to enhance the services of the Clinically Integrated Network (CIN)

What to Expect (Job Responsibilities):
- Identify and engage with benefit plan members regarding network steerage
- Monitor health benefit claims for utilization trends outside of the Enhanced Network and report findings
- Conduct outreach to new benefit enrollees to enhance their understanding of Enhanced Network benefits
- Document all member outreach attempts and engagement in the CIN's data and analytics platform
- Maintain the contract administration system and ensure records are filed accordingly

What is Required (Qualifications):
- High School Diploma or GED
- Minimum of 5 years' experience in a healthcare-related field and/or 5 years' experience in customer service, sales, account management, or a related field
- Ability to navigate and utilize various platforms including Innovaccer, EPIC, ACO MS, Meditract, KHIE
- Strong documentation and reporting skills
- Excellent communication and interpersonal abilities

How to Stand Out (Preferred Qualifications):
- Experience in engaging with members in a healthcare setting
- Familiarity with Clinically Integrated Networks (CIN)
- Knowledge of health benefit claims and utilization trends
- Background in strategic project management or event coordination
- Skills in data analysis and reporting

#HealthcareServices #MemberEngagement #CareerOpportunity #CommunityHealth #HealthcareCareers

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