Team Lead - Provider Contracting

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Job description

Overview:
What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!

The Team Lead - Provider Contracting (The Lead) is responsible for supporting the Contracts Managers in the maintenance of provider contracts and letters of agreement. The Lead will ensure timely renewal of all contracts to ensure continued network participation. Manage the contract lifecycle ensuring compliance throughout the process, and any necessary communication with providers to address inquiries and troubleshoot concerns. Follow up on escalated internal emails sent to the Contracting Department requesting contract information.

Key Responsibilities:

Work closely with the Provider Contracting leadership and other IEHP departments in ensuring contracting processes and data integrity is maintained.

Resolve escalated issues related to contracts negotiation and communication with providers to follow-up on any efforts to establish contracts.

Oversee and support contracts managers in drafting letters of agreement, communication with providers and internal departments.

Provide direction to contracts managers in troubleshooting any provider concerns related to contract upload that may affect accurate payment.

Lead contracts managers in resolving questions related to contracting negotiation.

Ensure expiring contracts are renewed within required timeframes. This includes ensuring oversight of required reporting and contracts renewal activities.

Work closely with the department leadership and other departments in closing provider network gaps to ensure appropriate Member care needs coverage.

Serve as a mentor and trainer for new contracts managers by advancing the knowledge and growth through support and guidance in the Provider Contracting policies, procedures, and workflows.

Support LEAN initiatives via RIE participation as requested.

Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits:
Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

CalPERS retirement

457(b) option with a contribution match

Generous paid time off- vacation, holidays, sick

State of the art fitness center on-site

Medical Insurance with Dental and Vision

Paid life insurance for employees with additional options

Short-term, and long-term disability options

Pet care insurance

Flexible Spending Account - Health Care/Childcare

Wellness programs that promote a healthy work-life balance

Career advancement opportunities and professional development

Competitive salary with annual merit increase

Team bonus opportunities

Qualifications:
Education & Experience

Four (4) years of experience in a Managed Care environment, emphasis on Provider contracting

A minimum of three (3) years of direct experience in Provider contracts

Experience with leading team and provide day to day direction

Bachelor's degree from an accredited institution required

In lieu of required degree, a minimum of four (4) years of additional relevant work experience is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above

Key Qualifications

Ability to establish and maintain effective working relationships with others.

Strong knowledge of contracting structures and payment methodologies required.

Provider contracting and analytical skills with emphasis on time management, financial analysis, and problem solving. Proficient in microcomputer applications (Microsoft Word, Excel, Spreadsheet, and Pivot Tables).

Excellent written and verbal communication and interpersonal skills. Strong organizational skills and sound decision-making skills required.

Start your journey towards a thriving future with IEHP and apply TODAY!

Work Model Location:
This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA)

Pay Range:
USD $43.87 - USD $58.13 /Hr.

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