Contracting Specialist

General Information

Position Purpose

We are looking for an individual with a depth of knowledge and experience in provider and payor contracting. This role will assist the Executive Director in the full life cycle of contracting work, including managing communications with new and current practices, preparing and distributing amendments, tracking changes, and updating the team on changes. This is a detail-oriented role with deep and meaningful connections across the Monument Health enterprise. A successful candidate will possess knowledge of the current, and surrounding, Monument Health geographies, fee-for-service and value-based contract approaches, and an ability to track multiple processes and projects at once to a high specificity.

Essential Job Functions

• Assist with provider and payor contracting, including managing notification and amendment processes.
• Maintain integrity of contract templates, contract files, and correspondence templates.
• Prepare contract documents and monitor and track progress of all contract negotiations.
• Responsible for the quality control process of new and revised documents.
• Serves as a communication link between payors/providers and Monument.
• Maintain custom contract matrices for all network providers and payors.
• Investigate and problem-solve concerns relating to contracts.
• Maintain and manage a centralized contract repository, ensuring timely tracking of key milestones, obligations, and renewals.
• Manage the provider rosters for multiple value-based and fee-for-service programs.
• Assist with network growth and network adequacy activities, including presentation and marketing material development, and forecasting potential impact on overall contract performance and membership.
• Establish and maintain strong relationships with providers including hospitals, clinics, professional organizations, and ancillary service providers; ensuring a customer service-driven approach.
• Light housekeeping (shared by all employees).
• Protect Monument’s value by keeping information confidential.
• Review systems and processes and suggest or make modifications to address issues.
• Occasional travel is required for conferences and assignments.
• Perform other related duties as necessary for the purpose of ensuring the efficient and effective functioning of the organization.

Knowledge, Skills, Abilities, and Other Characteristics

• Minimum 3 years’ experience in healthcare such as contracting, medical claims, medical front/back office, or Provider Relations preferred.
• Must be a highly motivated and self-driven individual who can learn quickly and be comfortable in a fast-paced, start-up environment where direct feedback is regularly provided.
• Must work well independently and on a team, both in person, remotely, and in hybrid formats.
• Must be skilled in high-impact business communication and demonstrate strong critical thinking skills.
• Demonstrated ability to successfully manage direct reports, vendor or contractor relationships, and work.
• Advanced proficiency in Microsoft Office Suite or Google Office Suite.
• Must adopt and live the Monument Health core values.

Education and Certifications Requirements

Baccalaureate degree required.

Monument Health Overview

Monument Health, LLC is a joint venture capitalized in 2015 and owned by Intermountain St. Mary’s Regional Medical Center and Primary Care Partners. Monument Health facilitates the largest and most comprehensive clinically integrated network (CIN) on Colorado’s Western Slope and delivers high-impact population health services. The high performing integrated network and population health services allow for better, more coordinated care and cost containment in the communities it serves.

Monument Health currently manages a network of 100,000+ members across the Western Slope, encompassing Commercial, Medicaid, CHP+, Medicare, Medicare Advantage, and Dual Special Needs (D-SNP) insurance plans with multiple payors. Self-funded employer groups may also utilize the Monument Health network and population health services on their TPA platforms. In addition, Monument Health offers analytics, population health and employee-based wellness programs and services.

Physical Aspects of the Job – Regularly Required to Perform Job Tasks

Physical Requirements 

Lifting Requirements

Working Environment

Vision Requirements

Hearing Requirements

Mental Requirements

OSHA Category Classification: Category III

The normal work routine of this position does not involve exposure to blood, body fluids, or tissues. The person holding this position will not be called upon to perform or assist in emergency medical care or first aid or to be potentially exposed in some way. Category III does include handling of implements, utensils, equipment; using public restrooms and public telephones; and personal contacts such as handshaking.