at MultiPlan in Naperville, Illinois, United States
Job Description
JOB ROLES AND RESPONSIBILITIES:
1.Oversee Network Development submission of all contract types, exhibits, amendments, addendums, and fee schedules.
2.Act as liaison between Network Development and other departments. Attend weekly Network Development training workshops.
3.Follow complete electronic tracking and loading process for all contract types.
4.Represent assigned functional areas and serve as subject matter expert committee member.
5.Interact with Medical Director on credentialing, certification and insurance issues.
6.Serve as subject matter expert for contracting staff regarding reimbursement methodologies, language, non-standard language changes/contract forms and certification and credentialing requirements.
7.Identify and present opportunities for process improvement. Identify and correct, with appropriate staff involvement, non-acceptable language, rates and other exhibits.
8.Maintain timely recording of status, new accounts, transfers, etc., in system of record (Salesforce). Investigate and maintain weekly load reports to assure contracts are accurately loaded and monetizing.
9.Manage and track the non-standard language process (NSL) including establishing a tracking system for changes that need to be tracked by region as per the NSL guidelines.
10.Collaborate with Sales/Account Management and Network Development to record Client Exclusion Additions and Removals.
11.Collaborate, coordinate, and communicate across disciplines and departments including Contract Administration.
12.Ensure compliance with HIPAA regulations and requirements.
13.Demonstrate Company's Core Competencies and values held within.
14.The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB SCOPE
This position manages the contract implementation process and is considered to be a fully competent professional who knows and applies a broad knowledge of principles, practices, and procedures related to the implementation of provider network contracts. Evaluation, originality, and/or ingenuity are required to complete job responsibilities. An incumbent works independently and has general latitude and discretion to make commitments with occasional need to confer with their supervisor to obtain guidance on the preferred approach to resolution of situations outside the standardized procedures. The incumbent understands when to escalate a contract issue to the next higher level and ensures that decisions consider the full implications (business, legal, and competitive) to both the Company and the customer. While this position does not directly manage others, an incumbent provides mentorship as well as project or work direction to less experienced Provider Contractors who may be assigned to work with them on a project or team basis.
As an Equal Opportunity Employer, the Company will provide equal consideration to all employees and job candidates without regard to sex, age, race, marital status, sexual orientation, religion, national origin, citizenship status, physical or mental disability, political affiliation, service in the Armed Forces of the United States, or any other characteristic protected by federal, state, or local law. Â Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
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