Healthcare Provider Network – Contract Management Specialist

Cobalt Benefits Group, LLC (DBA: Blue Benefit Administrators, CBA Blue & EBPA)

. Implement, configure, and maintain client-specific provider contracts, reimbursement methodologies, pricing arrangements, and related system records .

Posted 9/25/2026full-timeProvidence • Rhode Island • United StatesMid-LevelSenior💰 $55,000 - $65,000 per yearWebsite

About the role

Key responsibilities & impact

Implement, configure, and maintain client-specific provider contracts, reimbursement methodologies, pricing arrangements, and related system records
Validate contract configuration against approved client requirements, source documentation, fee schedules, and reimbursement methodologies
Develop, document, and execute contract testing scenarios to ensure accurate pricing, reimbursement, and claims processing outcomes
Coordinate contract implementation and maintenance activities with internal departments, network partners, clients, and other stakeholders
Maintain organized and accurate documentation related to provider networks, contracts, pricing arrangements, affiliations, tiering structures, and implementation decisions
Support provider network tiering setup, validation, testing, and ongoing maintenance activities
Monitor medical and dental network changes to ensure updates are implemented accurately, consistently, and in a timely manner
Perform provider contract and pricing maintenance, including identifying and resolving configuration discrepancies
Import and analyze 835 and 837 electronic claim files to support contract validation, reimbursement analysis, and provider maintenance activities
Respond to provider, network, and contract-related requests within established service standards
Support audits, quality reviews, issue resolution, and continuous improvement initiatives related to provider data, contract configuration, network maintenance, and reimbursement accuracy

Requirements

What you’ll need

Associate degree or equivalent combination of education and experience
Three or more years of related experience preferred
Working knowledge of Microsoft Office applications, including Outlook, Excel, and Word
Experience with provider contracts, provider network maintenance, reimbursement validation, contract configuration, or healthcare network tiering preferred
Experience working with 835 and 837 electronic claim files preferred
Strong customer service skills with a commitment to supporting internal and external stakeholders
Excellent organizational, analytical, and problem-solving skills
Ability to prioritize work, manage multiple assignments, and work independently in a fast-paced environment
Strong written and verbal communication skills
Participation in E-Verify to confirm employment eligibility of all new hires

Benefits

Comp & perks

Website LinkedIn All Job Openings 51 - 200 employees 💼 Consulting ⚖️ Legal 🛡️ Insurance Consulting
Legal
Insurance Cobalt Benefits Group, LLC (DBA: Blue Benefit Administrators, CBA Blue & EBPA) is a full service Third Party Administrator (TPA) that specializes in the customization, marketing, and operation of self-funded employee benefit plans. With over 30 years of experience and a team of over 195 employees, CBG provides a wide array of products and services including self-funded medical and dental plans, Flexible Spending Accounts, Health Reimbursement Arrangements, and COBRA management. CBG aims to assist employers in building custom benefit plans while managing costs and ensuring compliance with regulations.