Contract Specialist II - Hybrid

UPMC; Pittsburgh (Allegheny County); Híbrido; USD 60 000 - 80 000; Tempo integral

Resumo da oferta

UPMC Community Care Behavioral Health is hiring a full-time Contract Specialist II. The role is based in downtown Pittsburgh, with a hybrid schedule (in-office Monday, Wednesday, and Thursday).

The specialist will manage the contracting process from provider identification through execution and filing, including credentialing and licensing changes. Responsibilities include updating provider demographics, responding to internal inquiries, assembling DOE/DPW filings, reviewing applications, and

Qualificações

• Responsibilities reflect contract and credentialing coordination.

Responsabilidades

• Coordinate the addition of new provider demographic information into UPMC Health Plan systems.
• Respond to inquiries regarding provider network from internal departments.
• Assemble binders for Department of Health and DPW filings.
• Review provider applications, request missing information, and submit to credentialing.
• Coordinate provider file changes with the provider information department.
• Custodian for all Network and Vendor Relations Contract Files.
• Ensure contracts are fully executed and filed.
• Respond to inquiries from internal and external customers.
• Coordinate mailing to providers regarding contracting issues or changes.

Descrição da oferta de emprego

UPMC Community Care Behavioral Health is hiring a full-time Contract Specialist II. The team is headquartered in downtown Pittsburgh at the U.S. Steel Tower. This position will work in a hybrid model, with a few in office days each week – Monday, Wednesday and Thursday.

The Contract Specialist II is responsible for facilitating a seamless process from the time a provider is identified as needed in the network to contracting with the provider for services. The Contract Specialist II reviews any alterations in the status of contracted providers that may impact on their ability to continue to be in the provider network including changes in license, certifications, Medical Assistance enrollment and completing precedential requirements. Maintains the contract files for all provider types.

Responsibilities:

• Coordinate the addition of new provider demographic information into UPMC Health Plan systems.
• Respond to inquiries regarding provider network from other internal departments such as Marketing and Government Programs.
• Assemble binders for Department of Health and DPW filings.
• Review provider applications, request missing information, and submit completed application to credentialing.
• Coordinate provider file changes with the provider information department.
• Custodian for all Network and Vendor Relations Contract Files.
• Assure that provider contracts are fully executed by both parties and that contract copies are filed.
• Provide support to the Network and Vendor Relations Department by responding to inquiries from internal and external customers.
• Coordinate mailing to providers relating to new contracting issues or contract changes.