Contract Specialist, Provider

Responsibilities Manage and support provider contracts for all lines of business including Commercial, Medicare, and Medi-Cal HMO and PPO for multiple medical groups and Independent Physician Associations throughout California. Draft provider contract agreements and amendments, Letter of Agreement negotiation and analysis, contract terminations, maintain contract file integrity in the contract management system, maintain ancillary grid, and contribute to the operational implementation of all provider agreements. Collaborate with the Contracting Department, internal and external stakeholders to support successful execution of departmental and company goals. Handle complex provider inquiries and/or problems related to operations, contract interpretation (e.g., DOFR, delegation), claims, and facilitate resolution. Maintain favorable relationships while protecting the company’s interests. Serve as liaison between providers and internal departments (e.g., management, finance, medical services, claims, configuration, network management, customer service, legal, compliance). Assist with planning and scheduling routine payer joint operations committee meetings with large provider groups and hospitals. Develop and/or improve provider contracting tools, resources, contract language, physician education materials, job aides, policies and procedures (e.g., contracting workflows, value‑based contracts, physician resources for billing). Manage and participate in the development and implementation of systems (e.g., Symplr/sPayer, Epic) supporting network operations and management to encourage standardization and maximize functionality. Manage departmental intranet webpages; update content with tools and resources to ensure accuracy. Develop and manage contracting communications, including distribution of fully executed contracts to ensure accurate and timely configuration of contract terms in the Epic system. Contract management and maintenance: routing documents for signature, tracking signatures, uploading contracts into the database (e.g., Symplr/sPayer). Effectively support provider negotiations to achieve contracting strategy and attain budgeted results on time. Analyze data and collaborate with colleagues and business partners to identify root causes of issues. Collaborate with internal stakeholders to develop provider value‑based contracts. Drive change and innovation through implementing value‑added solutions to meet company goals. Advocate providers’ needs to internal stakeholders to create mutually beneficial solutions. Ensure visibility and resolution of operational issues related to provider relationships. Assist in the preparation and review of contract documentation for accuracy and contract terms/history. Research, gather, and organize provider contracts for audits, projects, and negotiations. Participate in departmental staff cross‑training to continuously improve the department. Complete projects within scheduled time frames and established standards. Travel may be required based on business needs. Qualifications College degree or equivalent experience. Minimum 3‑5 years of experience in managed‑care provider network. Basic financial analysis experience. Minimum 2 years of contracting or physician relations experience in responsible positions in health care contracting. Compensation & Benefits Base salary: $75,000‑$90,000 per year. Competitive compensation package that reflects experience, credentials, and education. Robust benefits program: excellent medical, vision, and dental coverage. 401(k) savings plan with company match. Flexible time off and 9 paid holidays. Altais and its subsidiaries are committed to equal employment opportunity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status, disability status, or any other classification protected by Federal, State, and local laws. #J-18808-Ljbffr