Network Contracting Specialist - Temporary

Job Description

Job Description

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The Company:

AlohaCare is a local, non-profit health plan serving Hawai`i’s low-income residents with free Medicaid and dual Medicare health insurance coverage. Our members include children, seniors, and adults residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care. Our approach is to meet the whole-person health and social needs of members. Through our community partnerships we offer innovative services such as connection to social service agencies, Native Hawaiian healing services, and in-home primary care for qualified members. Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all. We are Hawaii’s third-largest health plan and offer a wide network of quality primary care, specialists, hospitals, pharmacies and among many other providers across the state.

The Culture:

AlohaCare employees have a passion for helping Hawai`i’s most underserved communities. Our caring culture is fundamental to our company-wide team approach to providing high quality services. We support our employees with a supportive and positive work environment, healthy work-life balance, continuous communication, and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization-wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust-building. We encourage open-door, two-way, and frequent communication.

AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug, and vision insurance, paid time-off, 401k employer contribution, referral bonus, and pretax transportation and parking program.

The Opportunity:

AlohaCare requires providers to contract with us in order to provide services to our members. The Network Contracting Specialist is essential to providing excellent customer service to our providers by performing tasks accurately and timely in accordance to Network Contracting and other pertinent AlohaCare policies and procedures. These activities impact the provider’s ability to be included in AlohaCare’s provider network and ability to render services to AlohaCare members. In addition to adhering to established department standard operating procedures and performance timelines, day-to-day tasks will require use of critical thinking and time management skills to manage multiple projects and associated activities. All department and staff activities impact Network Contracting’s ability to evaluate overall department performance metrics and meet priority department, organizational, and strategic goals.

Primary Duties and Responsibilities:

• Monitor and process incoming faxes, mail, and emails related to contracting activities.
• Enter and monitor data into applicable department tracking tools/applications per workflows and policy and procedure.
• Perform distribution of time sensitive contract related documents and correspondence as follows:
  • Daily mail processing including standard and certified.
  • Daily mail, email, and fax distribution of time sensitive documents and correspondence to appropriate staff.
  • Monitor and respond timely to interdepartmental emails.
  • Provide support with fax distribution advisories and correspondence as needed.
• Organize, prioritize, communicate, and manage workload effectively and efficiently.
• Responsible for preparing and issuing new and amended provider contracts including, but not limited to the following:
  • Preparation of standard provider contracts and welcome packets (if applicable) according to provider type.
  • Routing and monitoring of provider contracts and amendments for signature (internally and externally). Follow up with parties until documents are executed.
  • Maintenance of contracts (soft and hard copy files).
• Assist with preparation, tracking, and maintenance of reports necessary to carry out the functions of the department.
• Organize, track and support manager in responding to provider fee increase requests.
• All other duties assigned.
• Adhere to regulatory compliance and quality guidelines as well as AlohaCare policies and procedures.
• Responsible for maintaining AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules, and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

Requirements:

• High school diploma or equivalent.
• Minimum of 1 year of experience as an Administrative Assistant or Office/Project Coordinator.

• Achieves results, builds trust, communicate effectively, customer and quality focused.
• Strong interpersonal and facilitation skills with the ability to communicate with all levels of the organization.
• Strong, effective, and precise written and oral communication skills; speak clearly and persuasively in positive or negative situations.
• Professional telephonic etiquette skills.
• Ability to solve problems, analyze, think critically and make good judgment.
• Strong customer service skills and be able to work in a diverse, demanding and evolving environment with strong conflict and problem resolution skills.
• Able to work independently with minimal supervision.
• Able to effectively work in a fast-paced and changing environment, manage multiple projects and priorities across multiple teams/projects and in a matrixed environment.

• Possesses excellent time management and organizational skills; is dependable, enthusiastic, self-starting, and self-motivated. Uses time effectively, reacts professionally under pressure.

• Intermediate skills using Microsoft Office; Word, Excel, Outlook and PowerPoint.
• Experience in the operation of general office equipment to include PC, fax/copy machine and phone system.

Preferred Requirements:

• Previous experience working in the Medical or Health Plan environment.
• Experience in contract terms and conditions.
• Experience using SalesForce.
• Word Processing skills of 45-60 wpm with a high degree of accuracy.

Mental, Physical and Environmental Demands:

• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
• In office working environment.
• May require prolonged sitting- up to 4 hours.
• Requires prolonged operation of a computer workstation, including the ability to type for extended periods of time on a keyboard during the scheduled workday. ?

Salary Range: $19.00 an hour

Temporary hire through December 31, 2026

AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veteran status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.