Provider Contracting Liaison - Inland Empire Health Plan : Job Details

Provider Contracting Liaison

Inland Empire Health Plan

Job Location : Rancho Cucamonga,CA, USA

Posted on : 2025-02-27T07:29:45Z

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 Provider Contracting Liaison is responsible for supporting the Contracting Department in the coordination of intra and interdepartmental areas including Contracting, Contracts Administration, and any other department that interacts with the Contracts Department related to contracts and letters of agreement (LOA) status. Effective management of department email inbox, which includes responses within established service level agreements (SLAs) until full resolution. This position is responsible for assisting in the timely completion of member specific and blanket LOAs, including timely communication with appropriate stakeholders, system updates, and submission to the Contracts Administration team for final execution.

Key Responsibilities:

  • Collaborate with the Contract Managers in the collection of documentation needed from providers for new contracts. Collection of licensures, certificates of insurance and any other collateral as needed to update contract.
  • Track provider letters of interest (LOIs) assigned to the Contracts Team (from receipt to execution). This includes running reports on open LOIs and closing out, monitoring LOIs activities and timely completion.
  • Collaborate with other departments to successfully complete all member specific and blanket Letters of Agreements (LOAs) within established SLAs to ensure Member care is not disrupted. Review if provider is on existing contract and work with the Contracts Manager on potential contract needs.
  • Review and assess trends of members that may require longer LOA terms to ensure continuity of the care is not disrupted.
  • Serve as the Contracts Department primary contact and manage internal inbox and respond to inquiries within established SLA or delegate to appropriate team member. Ensure all emails are responded within SLA, including those delegated to Team Members.
  • Work closely with the Contract Manager on processing new contracts, amendments, and contract renewals to ensure timely execution. The liaison will see the process through from start to finish (tracking in WorkFront) and act as a liaison between the CM and Provider, communicating updates and deficiencies.
  • Provide expertise and knowledge in maintaining accurate provider information in contract databases, which includes collecting necessary collateral for required NDDB updates ensuring contracts data integrity.
  • Troubleshoot any provider concerns related to contract upload that may affect accurate payment. Act as the liaison between Providers and the Contracts Department to ensure Providers are assisted promptly by the appropriate IEHP department.
  • 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 IEHPs 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

    • Three (3) years of experience in a Managed Care environment with an emphasis on Provider contracting
    • Bachelors 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

    • Understanding of managed care provider contracting
    • Knowledge of contracting structures and payment methodologies preferred
    • 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
    • Ability to establish and maintain effective working relationships with others

    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 $27.43 - USD $35.66 /Hr.
    Apply Now!
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