Contract Specialist

• Develop and maintain the Network Plan and provider handbook
• Evaluate network adequacy
• Ensure the network meets URAC and DoD standards
• Ensure compliance with all elements of the TRICARE Management Activity contract
• Establish effective working relationships with community stakeholders to increase resources and collaboration
• Represent and serve as spokesperson for US Family Health Plan internally and externally
• Educate providers and network members on Health Plan criteria and processes
• Manage non-clinical utilization management functions of the Health Plan
• Ensure compliance with the DoD contract regarding network and utilization issues
• Support provider contracting and network relations
• Lead contract negotiations for reimbursement terms and contract language with hospitals, physician groups, and ancillary service providers
• Conduct negotiations and complete contracting processes in accordance with USFHP contracting principles, organizational policies, procedures, and the TRICARE Management Activity contract

Explore Senior Provider Network Contract Specialist at Providence. Review requirements and application details.