Job Description
This position is accountable for review of content and accuracy of contracts, compliance with processes, policies and procedures, utilizing the Provider Relations Management System (PRMS). Audit responsibilities, both external and internal, focusing on business and regulatory requirements. Manages contract and compliance related project workgroups and has oversight of systems functionality, including process improvements.
This position requires high attention to detail. The ideal candidate will have intermediate to advanced skills with Microsoft Word, Excel, Access, PowerPoint, and Visio.
Job Requirements
Education Minimum Education Requirements Bachelors Degree Health Care Administration or related field or a combination of education and 7 years experience in healthcare provider contracting and compliance related functions. Preferred Education Bachelors Degree Health Care Administration
Knowledge/Skills Minimum Knowledge/Skills Requirements Intermediate knowledge of healthcare contracting and regulatory requirements. Excellent organizational skills. Excellent verbal and written communication skills. Intermediate expertise in data analysis, system functions/capabilities, Word, Excel, Access and Visio. Ability to lead project work groups and handle demanding workload and balance multiple tasks Preferred Knowledge/Skills Advanced expertise in healthcare contracting regulatory and legal requirements and analytical knowledge of systems programming and applications development. Expertise in interpretation and use of contract language
Experience Minimum Experience Requirements 5 years experience involving healthcare provider contracting and aspects of healthcare compliance. Experience with collection and analysis of healthcare data/information. Experience in project management and staff management. Preferred Experience Unspecified
License/Certifications Minimum License/Certifications Requirements None Required Preferred License/Certifications None Required
Group Health is an Equal Opportunity Employer committed to a diverse and inclusive workforce.
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