Provider Contract Specialist – Medicaid & LTSS

Driscoll Children's Hospital; Corpus Christi (TX); On-site; USD 60,000 - 90,000; Full time

Job summary

Driscoll Children\'s Hospital is seeking a Provider Contract Specialist to develop, monitor and manage provider contracts for Medicaid, CHIP and LTSS. The role collaborates with multiple departments to finalize and implement contracts, amendments, and related documents while ensuring data integrity and regulatory compliance.

Responsibilities include coordinating contracts, LOAs, and terminations, maintaining tracking systems, and supporting amendments and reimbursement language changes in a

Qualifications

• Associate's degree or equivalent from two-year college in a related field.
• Bachelor's degree from four-year college preferred.
• Two years’ experience in health care provider contracting.
• One year experience in health care provider relations, network management, or related work.
• Prior managed care and LTSS experience preferred.

Responsibilities

• Coordinate receipt and processing for provider contracts, delegation agreements, LOAs, termination notices, extension letters, etc.
• Collaborate in preparation, execution, distribution and tracking of all new or re-contracting agreements for Medicaid, CHIP and LTSS providers.
• Perform basic research to determine the legal names of provider/group/facility and enrollment status.
• Ensure LTSS providers are enrolled with HHSC at time of enrollment request.
• Maintain contracts and updates using various systems; manage contract tracking and status logs.
• Monitor LTSS provider activities by tracking contract terms and compliance; conduct audits as needed.

Education

Associate degree or equivalent from two-year college in a related field

Bachelor's degree preferred

Two years healthcare provider contracting

Health care provider relations/network management experience

Managed care and LTSS experience preferred

Job description

Driscoll Children\'s Hospital is seeking a Provider Contract Specialist to develop, monitor and manage provider contracts for Medicaid, CHIP and LTSS. The role collaborates with multiple departments to finalize and implement contracts, amendments, and related documents while ensuring data integrity and regulatory compliance.

Responsibilities include coordinating contracts, LOAs, and terminations, maintaining tracking systems, and supporting amendments and reimbursement language changes in a