Essential Functions:
Contract Management & Tracking:
- Assist in the preparation, execution, and tracking of provider contracts, amendments, fee schedules and single case agreements.
- Maintain an organized contract database and ensure timely updates to reflect changes in agreements.
- Monitor contract expiration dates and facilitate renewal processes in collaboration with leadership.
Network Development & Support:
- Support provider recruitment efforts by preparing contract packets and assisting with credentialing coordination.
- Respond to inquiries from providers regarding contract terms, reimbursement rates, and participation requirements.
- Assist in network adequacy reporting and analysis to ensure compliance with Texas HMO regulations.
Data & Compliance Management:
- Ensure provider data integrity within internal systems, coordinating updates as needed.
- Support regulatory compliance efforts by assisting with audits and reporting related to network contracts.
- Collaborate with internal departments such as claims, credentialing, and provider relations to resolve contractrelated issues.
Administrative & Operational Support:
- Prepare reports and presentations related to network contracting activities.
- Assist with meeting coordination, including scheduling and documentation of key discussions.
- Perform additional duties as assigned to support network management objectives.
Knowledge, Skills and Abilities:
- Fee Schedule Review
- Basic Knowledge of Credentialing Process
- Contract Terms