• Job Description

  Req#: R28711

  Workforce Classification:

  Telecommuter

  
  

  Join Our Team: Do Meaningful Work and Improve People’s Lives

  Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

  Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace.

  Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/ .

  We have an opening for a Provider Contract Administrator ! The Provider Contract Administrator manages all aspects of the provider contract including development of system logic and requirements for the generation and retention of network contracts in the Provider Information and Contract Management system. Development, maintenance and distribution of contract template documents, with the development of appropriate procedures for using the documents, ensuring all contract documents loaded to the repository are compliant. Acts as the point of contact for all issues and questions related to the contract document process. Collaborating across Health Care Economics, Legal, Pricing Configuration, Provider Information, and Provider Network Management &Solutions to ensure all interest are met as well as moving the contracting process along. In addition, they are responsible for the accurate development, issuance, and regulatory filing of custom provider and facility contract documents for the most complex Premera and LifeWise provider arrangements.

  What you will do:

  • Manage the contract library by uploading and configuring XML contract templates with appropriate variables and alternate terms for use by employees creating provider specific contracts.
  • Test contract templates, troubleshoot issues, partner with the system vendor as needed, and define a schedule for library maintenance.
  • Create and implement efficiencies with Contract Library.
  • Communicate all contract library changes and updates to all users.
  • Interpret contract requests from Network Management for the development, issue, execution, and activation, while ensuring compliance of provider contracts for complex provider groups and facilities.
  • Manage timelines and deliverables for contracts and OIC filings.
  • Support implementation of new provider networks; including participation in cross-departmental implementation work groups.
  • Research, analyze and provide interpretation on complex and abstract contracting issues.
  • Collaborate with other Premera/LifeWise departments to ensure that benefit and administrative provisions for assigned contracts are consistent with contractual intent and regulatory requirements and have appropriate approvals.
  • Complete required state regulatory filings for assigned contracts. Serve as the primary resource in resolution of regulator issues and inquiries related to those filings.
  • Identify and resolve contract and compliance issues relating to implementation of customized contracts.
  • Develop and maintain a strong positive collaborative relationship with partner departments.
  • Lead and/or participate in cross-departmental work groups as required in carrying out new network, product, benefit, policy implementation functions and process improvements.
  • Train and mentor Contract Specialists.
  • Perform other duties as assigned.

  What you will bring:

  • High school diploma or GED. (Required)
  • Four (4) years of experience to include: (Required)
    • Three (3) years of experience contract processing, and/or technical writing with legal/regulatory research.
    • Two (2) years of experience researching health plan regulatory requirements, such as HIPAA, COBRA, and state insurance requirements.

  • Strong Microsoft Office skills. (Preferred)
  • Experience with XML. (Preferred)
  • College degree in related field. (Preferred)
  • Demonstrated training/auditing skills. (Preferred)
  • Four (4) years of experience in the healthcare insurance field including medical terminology knowledge. (Preferred)

  What you will gain:

  • End-to-end contract administration expertise (template development, contract issuance/execution, and repository governance).
  • Cross-functional partnership experience working with Health Care Economics, Legal, Pricing Configuration, Provider Info, and Network Management to move contracting forward.
  • Regulatory and compliance depth through handling complex contracting issues and completing/defending required state filings and regulator inquiries.

  Physical Requirements:

  The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation:

  • This is primarily a sedentary role which requires the ability to exert up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body.
  • This role requires the ability to keyboard and to communicate clearly and understandably in person, and over the telephone.

  Premera total rewards

  Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:

  • Medical, vision, and dental coverage with low employee premiums.

  • Voluntary benefit offerings, including pet insurance for paw parents.

  • Life and disability insurance.

  • Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.

  • Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.

  • Generous paid time off to reenergize.

  • Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.

  • Employee recognition program to celebrate anniversaries, team accomplishments, and more.

  For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.

  • Commuter perks make your trip to work less impactful on the environment and your wallet.

  • Free convenient on-site parking.

  • Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.

  • Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.

  • Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.

  • Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.

  Equal employment opportunity/affirmative action:

  Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

  If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.

  Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

  The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.

  The salary range for this role is posted below; we generally target up to and around the midpoint of the range.

  National Salary Range:

  $58,600.00 - $93,800.00

  National Plus Salary Range:

  $66,800.00 - $106,900.00

  *National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska .

  We’re happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We’re committed to creating an environment where all employees are celebrated for their unique skills and contributions.

• About the company

  Customer Service: 5 a.m. to 8 p.m. Pacific Call us at: 800-508-4722 in AK; 800-722-1471 in WA and other states Please don't post medical or other personal information or claims info/appeals here. Premera Facebook Fan Page Terms of Use This pa...

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