Northwest Permanente is seeking a Contract Coordinator in its Provider Contracting & Relations department. This position plays an integral role in the Provider Contracting Department by managing the contract document development process, including production, quality control, execution, signature approval tracking and final retention of documents. In partnership with the Contract Compliance Manager and Provider Contract Managers, this position ensures contract compliance with applicable state and federal regulations and standards, as well as legal, regulatory and accreditation requirements.
Primary Responsibilities:
- Works to create contract documents which are developed in conjunction with departmental policy, agreed upon financial provisions, care delivery requirements, and legal, regulatory, accreditation and compliance standards.
- Ensures departmental contract processes are followed, contracts are developed in accordance with strict guidelines, and final approvals are secured prior to execution, including identifying contracts which require filing with the State of Washington Office of the Insurance Commissioner (OIC), collaborates to draft and refine compensation exhibits and other contract language provisions.
- Builds and maintains effective partnerships with network and affiliated practitioners, provider groups, hospital and facility organizations in order to research, collect and maintain key demographic information related to contracts, provider entities, practitioners and locations in the appropriate systems for initial set-up.
- Researches claims issues including provider not found and provider demographics.
- Provides timely and accurate resolution to key constituents to ensure claims are processed in an expedient manner once a claims issue is identified.
- Communicates with provider, claims and provider relations personnel and Business Analyst to resolve pending claims.
- Determines whether claims received are contracted or non-contracted based on medical services rendered and billed, contractual relationship between rendering and billing provider, scope of contracted services, and configuration detail.
- Designs and develops specialized reporting tools related to contract operations and for use by management in the oversight of network development activities.
- Manages compliance and other departmental projects and initiatives including, but not limited to, facilitation of data gathering for internal audits, state and federal audits and assessments (e.g., CMS, Washington OIC, NCQA), corrective action plans, regulatory bulk amendments, development of reporting and tracking related to contract compliance initiatives.
Minimum Qualifications:
- Bachelor’s degree in business, legal or health care administration or equivalent experience is required.
- Minimum three (3) years’ experience in managed care contracting, physician relations or practice management, legal administration, health plan administration, project management, or other comparable office environment providing incumbent the skills necessary for the position.
- Familiarity with managed care contracting principles and language.
- Excellent project management, facilitation, and team building skills. Ability to plan, prioritize and deliver within constrained timelines.
- Ability to manage multiple and competing priorities.
- Ability to exercise a high degree of judgment, discretion, and confidentiality in dealing with sensitive contracting, financial and physician/practitioner personal information to which position has direct knowledge.
- Ability to work with a diverse group of people both internally and externally, including physicians, support staff, coworkers, management and executive leadership.
- Strong customer focus and relationship management skills.
- High level of computer proficiency in various software applications such as Microsoft office suite (Word, Power Point, Excel), Onyx, Cognos, and Contract Manager preferred.
- Advanced knowledge of applicable federal and state laws and regulations related to healthcare (in those pertaining to managed care contracting, NCQA, The Joint Commission, Medicare, Medicaid, Washington Office of the Insurance Commissioner) preferred.
For more information about this position, contact Marisa Walter, marisa.e.walter@kp.org.
About Northwest Permanente:
We are the Permanente in Kaiser Permanente. Northwest Permanente is a self-governed, multi-specialty group of 1,500 physicians, clinicians, and administrative professionals caring for 630,000 members in Oregon and Southwest Washington. Together with Kaiser Foundation Health Plans and Kaiser Foundation Hospitals, we form Kaiser Permanente of the Northwest, an integrated health care program. Kaiser Permanente is one of the nation's preeminent health care systems, a benchmark for comprehensive, integrated, value-based, and high-quality care.
Our Northwest Permanente administrative professionals enjoy a wide range of company sponsored benefits:
- 15% employer contribution to retirement programs, including pension
- 90% employer-paid health plan
- Tuition Reimbursement
- Child Care Benefits
- Flexible Work Schedules
- Paid Parental Leave
- Self-Care Days + Paid Time Off
Equal Opportunity Employer
Northwest Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.
