Healthcare Provider Contract Specialist

Secure your future with a direct-hire position as an employee of the company – this is not a temporary role, and you'll never pay a fee for our assistance.

As a proud partner of the company, Novus Group is dedicated to helping you succeed. We provide comprehensive support, including resume fine-tuning, personalized interview coaching, compensation insights, and end-to-end navigation of the employment process, leading you directly to an offer.

Location: [Downtown Pittsburgh, PA 15222] This role does offer some remote/work-from-home flexibility, but will require a regular presence in Pittsburgh, PA.

Travel: Occasional travel throughout the Pittsburgh, PA area

The Company, a non-profit healthcare organization, is a leader in providing high-quality, compassionate care to patients throughout Pennsylvania and beyond. With an extensive network of hospitals, clinics, and other medical facilities, the company is dedicated to improving the health and well-being of the communities they serve.

As the Health Provider Contract Specialist, you will play a crucial role in managing and negotiating contracts with our extensive network of healthcare providers. Leveraging your expertise in contract administration and financial analysis, you will ensure that our contractual agreements are favorable and compliant, enabling us to continue delivering exceptional care to our patients. This position is responsible for facilitating a seamless process from the time a provider is identified as needed in the network to contract with the provider for services. The Contract Specialist reviews any alterations in the status of contracted providers that may have an impact on their ability to continue to be in the provider network including changes in license, certifications, and/or enrollment by assisting with completing pre-credentialing requirements.

- Review and negotiate contracts with healthcare providers, including hospitals, clinics, and medical practices

- Analyze financial data and contractual terms to identify opportunities for improved cost savings and operational efficiency

- Ensure contractual compliance and maintain accurate records of all provider agreements

- Collaborate with cross-functional teams to address any issues or concerns related to provider contracts

- Stay up to date with industry regulations and best practices in healthcare contracting

- Bachelor’s degree in Business Administration, Finance, or a related field

- Minimum 3 years of experience in healthcare contract management or provider relations networking

- Demonstrated expertise in contract negotiation, financial analysis, and contract compliance

- Thorough knowledge of NCQA standards and other relevant external quality standards

- Knowledge of state and federal standards for contracting

- Strong communication and interpersonal skills to effectively liaise with healthcare providers

- Proficient in Microsoft Office suite, with the ability to analyze complex data and create detailed reports

A competitive salary is offered to new hires of up to $57,000 per year, commensurate with experience, as well as a comprehensive benefits package including health, dental, and vision insurance, retirement plan contributions, tuition reimbursement, and generous paid time off.

In addition to your base salary, you have the potential to significantly increase your earnings. We offer performance-based raises and pathways for higher pay through continuous learning and education, with the potential to reach up to $81,000 annually in this position.

Our organization is committed to providing equal employment opportunities to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law.