Hybrid Provider Network Contract Specialist III

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 70,000 - 95,000; Full time

Job summary

UPMC Community Care Behavioral Health seeks a full-time Contract Specialist III to streamline contract processes for providers added to the network. The role covers credentialing support, licensure changes, MA enrollment, and maintaining contract files in a centralized system.

Based in downtown Pittsburgh with a hybrid model (in-office Monday, Wednesday and Thursday), the position includes training new staff, coordinating electronic contracts, updating provider information, and supporting the

Responsibilities

• Respond to inquiries regarding provider network from other internal departments such as Marketing and Government Programs.
• Assure that provider contracts are fully executed by both parties and that contract copies are filed.
• Coordinate the addition of new provider demographic information into UPMC Health Plan systems.
• Review and approve specific inquiries related to credentialing and/or provider data maintenance.
• Participate in projects as assigned by Supervisor or Manager.
• Provide support to the Network and Vendor Relations Department by responding to inquiries from internal and external customers.
• Review provider applications, request missing information, and submit completed application to credentialing.
• Understand and train new staff on UPMC Health Plan products, policies and procedures including departmental policies.
• Coordinate the execution of electronic contracts to providers relating to contracting issues or contract changes.
• Coordinate provider file changes with the provider information department.

Job description

UPMC Community Care Behavioral Health seeks a full-time Contract Specialist III to streamline contract processes for providers added to the network. The role covers credentialing support, licensure changes, MA enrollment, and maintaining contract files in a centralized system.

Based in downtown Pittsburgh with a hybrid model (in-office Monday, Wednesday and Thursday), the position includes training new staff, coordinating electronic contracts, updating provider information, and supporting the