Contracts Specialist

Apply on line at http://www.alohacare.org/Careers/Default.aspx

AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.

AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication and a generous benefits package.

 

AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

 

These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.

AlohaCare requires providers to contract with us in order to provide services to our members. The Contracts Specialist is essential to providing excellent customer service to our providers by performing tasks accurately and timely in accordance to Network Contracting  and other pertinent AlohaCare policies and procedures. These activities impact the provider’s ability to be included in AlohaCare’s provider network and able to render services to AlohaCare members. In addition to adhering to established department standard operating procedures and performance timelines, day-to-day tasks will require use of critical thinking and time management skills to manage multiple projects and associated activities. All department and staff activities impact Network Contracting’s ability to evaluate overall department performance metrics and meet priority department, organizational and strategic goals.

·        Monitor and process incoming faxes, mail and emails related to contracting activities.

·        Enter and monitor data into applicable department tracking tools/applications per workflows and policy & procedure.

·        Perform distribution of time sensitive contract related documents and correspondence as follows:   

o  Daily mail processing including standard and certified

o  Daily mail, email and fax distribution of time sensitive documents and correspondence to appropriate staff.

o  Monitor and respond timely to interdepartmental emails.

o  Provide support with fax distribution advisories and correspondence as needed.  

•        Organize, prioritize, communicate and manage workload effectively and efficiently.

•        Responsible for preparing and issuing new and amended provider contracts including, but not limited to, the following:

o  Preparation of standard provider contracts and welcome packets (if applicable) according to provider type

o  Routing and monitoring of provider contracts and amendments for signature (internally and externally). Follow up with parties until documents are executed. 

o  Maintenance of contracts soft and hard copy files

•        Assist with preparation, tracking and maintenance of reports necessary to carry out the functions of the department.

•        Organize, track and support manager in responding to provider fee increase requests

•        Perfom special projects as assigned.

•        Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

•        Perform other duties and responsibilities, as assigned.

•        High School Diploma or Equivalent

•        1-3 years of experience as an Administrative Assistant or Office/Project Coordinator.

•        Able to work independently with a minimal amount of oversight.

•        Strong oral, written, and interpersonal communication skills in English, including telephone etiquette

•        Requires operation of general office equipment to include; PC, fax/copy machine and ACD Mitel Phones.

•        Intermediate skills using Microsoft Office; Word, Excel, Outlook and PowerPoint.

•        Achieves results while building trust by communicating in an effective way.

•        Ability to multi-task and adapt to a fast-paced environment with focus on attention to detail and quality.

•        Flexibility and ability to analyze and problem solve using critical thinking to make sound decisions that contribute to the overall team, departmental and organizational goals.

 

•        Previous experience working in the Medical or Health Plan environment

•        Experience in contract terms and conditions

•        Experience using SalesForce

•        Word Processing skills of 45-60 wpm with a high degree of accuracy.

•        In-office working conditions.

•        No environmental hazards.

•        Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.