Contracts Specialist - The Health Plan **Full Remote**

 
Position: Contracts Specialist - The Health Plan **Full Remote**

Job ID: 33672

Location: US-TX-Houston

Department: Contract Administration

Full/Part Time: Full time

Regular/Temporary: Regular

Shift: 8a-5p Monday - Friday

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.

Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.

To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.



Summary:

We are looking for a Contract Specialist -- someone who works well in a fast-paced setting. In this position, you will be responsible for supporting network management by completing research projects, processing and implementing provider agreements and provider changes, and answering provider calls. This position is also responsible for managing and completing major departmental projects.

Think you’ve got what it takes?
 

Job Duties & Responsibilities
•    Manages LOI process, prepares service forms for provider information and contract changes, works service flow queues for contract/application process
•    Monitors TMHP website for provider reimbursement changes on a monthly basis 
•    Provides ongoing support to network management department and other internal customers as needed
•    Answers network management’s main provider phone line and triage/resolve provider issues
•    Submits required reports, ad hoc reports, and completed projects to management in a timely manner
•    Demonstrates proficiency with software applications that are necessary to complete assigned tasks including but not limited to call tracking system and claims payment system as well as word processing, spreadsheet, database, and graphics software products
•    Maintains all boilerplate contracts
•    Reviews Texas Department of Insurance regulations and Texas Department of Health regulations as contractual obligations and recommends amendments to boilerplate contracts as needed 


Skills & Requirements
•    High school diploma or GED required
•    Two years’ health care or managed healthcare experience required
•    Bachelor degree may be substituted for the required experience
•    Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s, unless approved for a medical or religious exemption.



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