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Provider Contract Implementation Specialist I (Hybrid)

Health Care Service Corporation
United States, New Mexico, Albuquerque
5701 Balloon Fiesta Parkway (Show on map)
Aug 29, 2024

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary This position is responsible for reviewing Non-Standard Contracts for System Capacity, implementing and auditing contract completion, handling contract inquiries by conducting research and coordination through various departments in resolution and responding to inquiries, conducting contract analysis and modeling, conducting quality control and analysis of quality reporting, and preparing quality improvement recommendations.

JOB REQUIREMENTS:

  • Four years' experience working in a managed care/ healthcare environment.
  • Health care management database experience.
  • Knowledge of managed care products and provider contracting.
  • Knowledge of CPT, HCPCS, ICD9, Revenue code and/or DRG coding practices.
  • Project management experience, technical documentation, and leaderships skills.
  • Flexibility to meet deadlines in an environment of constantly changing priorities and workloads.
  • Analytical skills including modeling.
  • Verbal and written communications skills including interpersonal skills to work across the organization to resolve problems, responding to inquiries, compose procedure manuals and training materials, and to discuss business and technical aspects with all levels of management.
  • Knowledge with both mainframe and windows-based applications.
  • PC skills including Microsoft Office with proficiency in Excel.

PREFERRED JOB REQUIREMENTS:

  • Bachelor's degree

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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$39,900.00 - $88,800.00
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