Primary Care Capitation Contracts Compliance Specialist

Health & Human Services; North Carolina; Hybrid; USD 63,000 - 95,000; Full time

Benefits offered by this job

Health insurance options

Retirement plans

NCFlex benefits

Paid vacation & sick leave

Parental leave

Job summary

North Carolina Department of Health and Human Services (DHHS) seeks a Primary Care Capitation Contracts Compliance Specialist to oversee end-to-end procurement and contracts for the Rural Health Transformation initiatives. You will coordinate with legal teams to ensure compliant, scalable contract implementations and support public records requests related to the pilot.

The role requires paralegal experience or a related degree with substantial contract work, and offers the potential for hybrid

Qualifications

• Paralegal training or certification and three years of substantive paralegal work.
• Bachelor's degree with three years of paralegal experience.
• Alternative: GED plus seven years of paralegal experience performing delegated work.

Responsibilities

• Provide end-to-end procurement and contract support for the Primary Care Capitation Pilot.
• Manage RFP/RFI/RFQ processes and vendor agreements.
• Draft, review, and amend managed care contracts and downstream provider agreements.
• Coordinate with the Office of General Counsel and DHB Legal team for compliance and risk mitigation.

Skills

Legal research

Draft contracts

Contract management

Compliance monitoring

Regulatory knowledge

Education

Paralegal training/certification

Bachelor's degree in related field

GED with paralegal experience

Job description

About Us

North Carolina State Government is one of the state’s largest employers, with over 76,000 employees all working toward a common goal: a safer and stronger North Carolina. We are a large organization comprised of various agencies, offices, and universities, each providing important public services. Eligible state employees are entitled to comprehensive benefits, including a variety of leave options, professional development opportunities, insurance, and more. To learn more about the benefits of being a North Carolina state employee, visit the N.C. Office of State Human Resources' website. Permanent, temporary, and time-limited state government jobs can be found from the mountains to the coast. Find your next opportunity today!

Description of Work

The Primary Care Capitation Contracts Compliance Specialist provides end to end procurement and contract support for the Primary Care Capitation Pilot and related RHTP initiatives. The Specialist manages RFP/RFI/RFQ processes and vendor agreements; drafts, reviews, and amends managed care plan contracts and downstream provider agreements tied to the pilot; and serves as liaison between legal and business for pilot related questions. This role analyzes contract requirements and special provisions for compliance with applicable laws, regulations, and DHB procedures; and conducts research supporting procurement efforts, organizes audit ready documentation and supports public records requests tracking for pilot related matters. The Specialist coordinates closely with the DHHS Office of General Counsel, including the RHTP Assistant General Counsel and DHB Legal team, to ensure compliance, risk identification and mitigation, ensuring pilot model requirements are effectively implemented through health plan and provider contracts.

Salary and Contract

• Salary Grade Range: $63,367.00 - $95,051.00
• Recruitment Range: $63,367.00 - $80,000.00

Preferred Qualifications

• Ability to perform legal research in accordance with preliminary instructions as to methods or approach, source material available, and policy and precedent of the office.
• Ability to draft and prepare contractual instruments.
• Ability to create contracts which document timelines, deliverables and scopes of work.
• Ability to effectively monitor, track and manage contract requirements and compliance from initiation through closeout.
• Ability to understand and resolve complex problems and to read, interpret and make recommendations based on complex state, federal and Departmental rules, laws, and regulations.

Posting Information

• The Posting Will Close At 11:59 P.M. the Night Before The End Date
• The Position Is Time-Limited
• This Position Is 100% Federally Funded
• This Role Is Eligible To Be Hybrid

About the Rural Health Transformation Program

NC Rural Health Transformation Program is a statewide program led by NCDHHS to transform rural health care delivery, improve health outcomes, and ensure sustainable access to care for nearly 3 million rural North Carolinians. The program is funded over five years by the Centers for Medicare & Medicaid Services (CMS). The main goals of the program are to: Catalyze innovative health care models for rural communities by changing the way providers work together to care for patients in rural NC. Transform the rural care experience, building community-based clinical, behavioral, and social supports close to home. Create a sustainable rural health delivery system through underlying systems changes in rural workforce pipelines and care team models, and rural provider financial models.

Compensation and Benefits

• Health insurance options
• Standard and supplemental retirement plans
• The NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis)
• Paid vacation, sick, and community service leave
• Paid parental leave is available to eligible employees

Equal Opportunity and Employment First Philosophy

The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders.

We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job.

In accordance with the Governor’s Executive Order 303, our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved.

You are invited to apply for positions for which you may be qualified.

Qualifications and Experience

Graduation from an appropriately accredited institution for paralegal training and three years of experience as a paralegal OR Bachelor's degree from an appropriately accredited institution and three years of substantive paralegal experience OR High school or General Education Development (GED) diploma and seven years of paralegal experience performing delegated, substantive legal work OR an equivalent combination of education and experience.

EEO Statement

The State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.

Contact Information

If there are any questions about this posting, please contact Talent Acquisition at [e-mail].