Provider Contract Management Specialist

🕒 July 14

🥔 Idaho, Oregon, +2 more states – Remote

🥔 Idaho – Remote 🌲 Oregon – Remote ⛷️ Utah – Remote ☕ Washington – Remote

💵 $30 - $31 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🛒 Procurement

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Cambia Health Solutions

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Cambia Health Solutions is a nonprofit, mission-driven healthcare company based in Portland, Oregon, that operates consumer-focused health care and health insurance businesses and invests in health innovation. It serves as the parent organization for the Regence family of health plans and runs initiatives and subsidiaries focused on improving care delivery, providing insurance products, and developing digital health tools and services.

📋 Description

• Prepares, configures, and maintains provider contract documents and templates in the contract management system. • Conducts peer reviews and system testing of documents, templates, and configurations prior to production deployment. • Implements and coordinates provider contracts and reimbursement with Provider Operations, Provider Pricing, and Provider Enrollment staff. • Works cross-functionally with Network Management, Legal, and Regulatory Compliance teams to draft, coordinate, file, and revise provider contracts. • Serves as the central point of contact for contract management system training, troubleshooting, and support. • Maintains the integrity and accuracy of the provider contract database and repository. • Supports internal and external audits, triages claims and audit inquiries, processes Single Case Agreements.

🎯 Requirements

• Bachelor's Degree in healthcare, business or related field. • 3 years of experience in the healthcare industry with a minimum of one year project-related experience, or equivalent combination of education and experience. • Proficient in Microsoft Office and corporate software. • Action-oriented with the ability to organize, prioritize, and meet deadlines while producing accurate, detail-focused work. • Excellent oral and written communication skills for interfacing with internal and external contacts, including state regulatory bodies. • Strong teamwork and collaboration skills with peers, leadership, and cross-functional teams. • Proficient in contract management systems. • Skilled in contract filing software to manage regulatory compliance and state filing requirements accurately. • Familiarity with the Regence provider community, contracting protocols, reimbursement methodologies, and contract development processes desired. • Experience with AI tools and technologies to enhance productivity and decision-making highly desired.

🏖️ Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. • Annual employer contribution to a health savings account. • Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. • Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). • Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). • Award-winning wellness programs that reward you for participation. • Employee Assistance Fund for those in need. • Commute and parking benefits.