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Contracting Specialist

WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.

Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294404)

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

Supports the Provider Network Management Department by assuming the pivotal role of the primary liaison for provider contract implementation and support. An invaluable asset in streamlining the contract submission process and ensuring the seamless integration of provider information into systems, thereby fostering consistency in provider setup and unwavering adherence to best practices.

Our Investment in You:

• Full-time remote work

• Competitive salaries

• Excellent benefits

Key Functions/Responsibilities:

· Champion the contract submission process, diligently upholding corporate standards set by the Health Plan. Secure both digital and hardcopy versions of contracts, ensuring all internal contracts are accounted for and archived appropriately.

· Offer unwavering support to Contract Managers, stepping in whenever needed to facilitate the seamless flow of contract-related activities.

· Masterfully maintain intricate spreadsheets and excel at gathering, tracking, compiling, and disseminating statistical data for daily and monthly contracting reports.

· Play a vital role in collecting and meticulously recording provider contract information, a crucial component for the successful implementation and execution of new and existing provider contracts.

· Keep the contract organization's databases impeccably updated on a daily basis, fostering a culture of data accuracy and integrity.

· Foster seamless coordination with Contracting, Provider Enrollment, and Credentialing teams, ensuring absolute congruence across all Health Plan data systems.

· Under designated assignments, take charge of creating and dispatching provider contracts and amendments, demonstrating precision and efficiency.

· Contribute your expertise to the design and development of network development projects and other provider-related initiatives as assigned.

· Execute all duties and special projects with unwavering dedication, adhering to established timeframes without compromise.

· Maintain exceptional attendance, recognizing it as an integral part of the position's success.

· Showcase your autonomy and exceptional time management skills, expertly juggling multiple assigned tasks.

Supervision Received:

• Indirect supervision is received weekly.

Qualifications:

Education:

• Bachelor’s degree or an equivalent combination of education, training and experience is required.

Preferred/Desirable:

• Bachelor’s preferred

Experience:

• 1-3 years experience in insurance, healthcare or managed care required.

Certification or Conditions of Employment:

• Pre-employment background check

Competencies, Skills, and Attributes :

• Understanding of contractual documentation.

• Demonstrated competence using Microsoft Office products, primarily Word, Excel, and Outlook. Knowledge of FACETS Onyx systems helpful.

• Effective communication skills (verbal and written).

• Demonstrated ability to work both independently and as part of a team.

• Must possess excellent organizational skills and be detail oriented with an ability to meet critical deadlines.

Working Conditions and Physical Effort:

• Work is normally performed in a typical interior/office work environment.

• No or very limited physical effort required.

• No or very limited exposure to physical risk.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294404)

Important info on employment offer scams:

According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not reach out to individuals via text, we do not ask or require downloads of any applications, or “apps”, and applicant screenings, interviews and job offers are not conducted over text messages or social media platforms. We do not ask individuals to purchase equipment for, or prior to employment. To avoid becoming a victim of an employment offer scam, please followthese tips from the FTC (https://consumer.ftc.gov/consumer-alerts/2023/01/looking-job-scammers-might-be-looking-you?utm_source=govdelivery) .