Provider Contracts & Compliance Specialist

Ensuring that provider contracts are compliant with current state and federal requirements and that any corrective actions assigned to the Care Management Division are completed and documented. The Specialist also assists Care Management Division operations with obtaining any needed letters of agreement (LOA) with non-contracted providers when need medical services are not readily availbe in the AHF’s provider networks. Ensuring that its provider contracting operations are compliant with ever changing state and federal regulations and contracting documents, including provider recruitment materials are accurate and current. He or she ensures that AHF is up-to-date with contracting documents and templates. He or she, in collaboration with AHF’s IT Department, validates that provider network data submissions are error-free, which ensures compliance with state and federal network adequacy requirements and enrollee and primary care provider satisfaction. #J-18808-Ljbffr AIDS Healthcare Foundation