Overview

Managed Care Network Contract Specialist will initiate and maintain channels of communications with provider groups and facilities. The Managed Care Network Contract Specialist will manage single case agreements and network contracting reporting. Additional duties include: Fee Schedule reviews and analysis and adequacy reporting.

Responsibilities

Essential Functions:

Contract Management & Tracking:

• Assist in the preparation, execution, and tracking of provider contracts, amendments, fee schedules and single case agreements.
• Maintain an organized contract database and ensure timely updates to reflect changes in agreements.
• Monitor contract expiration dates and facilitate renewal processes in collaboration with leadership.

Network Development & Support:

• Support provider recruitment efforts by preparing contract packets and assisting with credentialing coordination.
• Respond to inquiries from providers regarding contract terms, reimbursement rates, and participation requirements.
• Assist in network adequacy reporting and analysis to ensure compliance with Texas HMO regulations.

Data & Compliance Management:

• Ensure provider data integrity within internal systems, coordinating updates as needed.
• Support regulatory compliance efforts by assisting with audits and reporting related to network contracts.
• Collaborate with internal departments such as claims, credentialing, and provider relations to resolve contractrelated issues.

Administrative & Operational Support:

• Prepare reports and presentations related to network contracting activities.
• Assist with meeting coordination, including scheduling and documentation of key discussions.
• Perform additional duties as assigned to support network management objectives.

Knowledge, Skills and Abilities:

• Fee Schedule Review
• Basic Knowledge of Credentialing Process
• Contract Terms

Qualifications

Minimum Education:

- High School Diploma or equivalent (higher degree accepted)

Minimum Experience:

- 2 years related experience.