Senior Contract Administrator - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 159435
JOB SUMMARY: Serves as the point of contact for Third Party Administration (TPA) services provided to key clients and the relations manager for key subcontractors/delegated entities.
Negotiates or assists the Director of Network Administration with TPA service and delegated entities contracts and/or related downstream provider agreements. As needed, collaborates with internal departments such as Compliance, Contracting, Provider Services, Configuration, Claims, Finance, Analytics, Legal Affairs, Medical Affairs, and Purchasing to ensure input into TPA services and delegated entities contracts prior to execution for optimal administrative efficiency, as well as accurate implementation and on-going reporting. Accountable for maintaining the relationship with TPA clients and delegated entities, ensuring contract compliance and resolution of various issues related to services, which may include, but are not limited to claims payment, invoice generation and payment receipt, provider access & availability, member/provider complaints and data reporting.
Bachelor's Degree required.
Four (4) years of equivalent work experience may substitute for degree requirement.
Work Experience (Years and Area):
Seven (7) plus years in healthcare with at least Five (5) years of experience in Managed Care contracting, Provider Relations, or Third-Party Administration relations.
PC, Phone, Fax, Scanner
SPECIAL REQUIREMENTS: 1. Communication Skills: Above Average Verbal (Heavy Public Contact) Writing/composing Correspondence Reports 2. Other Skills: Analytical Mathematics Medical Terminology P.C. Research Statistical Word Processing 3. Work Schedule: Flexible
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.