Join a mission-driven organization focused on improving healthcare for seniors and chronically ill individuals. As a Provider Contract Specialist, you will play a key role in expanding and maintaining a high-quality provider network in the San Antonio and New Braunfels areas. Working primarily remotely with regular local travel, you will directly engage with physicians and ancillary providers to secure contracts that meet regulatory and organizational standards.
Key Responsibilities
- Identify and recruit providers in designated specialties and regions to meet network adequacy requirements.
- Negotiate contract terms independently, addressing provider concerns and finalizing agreements within established guidelines.
- Prepare, review, and manage provider contracts, ensuring accurate documentation and compliance with internal and regulatory policies.
- Coordinate the collection of credentialing materials and track progress to support timely onboarding.
- Maintain up-to-date contract records and update tracking systems with precise contractual details.
- Respond to internal inquiries regarding provider contracting and support cross-functional teams with accurate, timely information.
- Process network updates including new enrollments, terminations, and demographic changes to keep provider directories accurate.
- Participate in internal meetings to support network development and organizational goals.
Qualifications
Candidates must have at least five years of direct provider contracting experience with an HMO, IPA, medical group, or healthcare institution. A high school diploma or GED is required; a bachelor’s degree is preferred, though additional relevant experience may substitute. Strong analytical, communication, and negotiation skills are essential. Proficiency in MS Word and Excel is required, with advanced Excel and Access skills highly valued.
This position operates on a hybrid schedule with Monday through Friday hours from 8 a.m. to 5 p.m. Central Time. Approximately 20% of the role involves local travel to provider locations. A valid driver’s license, auto insurance, and reliable transportation are necessary. The organization supports equal opportunity employment and welcomes applicants of all backgrounds.
