• Share :

Department(s):

Contracting

Reports to:

Manager, Contracting

FLSA status:

Non-Exempt

Salary Grade:

I - $61,000 - $99,110

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on

Monday, November 06, 2023 at 11:59 PM.

Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. * This position is eligible for partial telework in California.
• About CalOptima Health

CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together. ' - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

About the Position

The Contracts Specialist will assist in the coordination and implementation of certain provider contracts, monitor the department's maintenance tasks and provide analytical support for assigned contracts. The incumbent will be responsible for the maintenance and integrity of the contracting database and assigned contract templates, and system forms/letters. The incumbent will interact with department staff or other departments to ensure appropriate coordination of required tasks and assigned projects.

Duties & Responsibilities:

Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.

Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.

Assists Contracts Managers in entering contracts into the database and stores contracts on department Share drive folders and/or SharePoint sites, as required.

Assists in preparing, analyzing and reporting contract compliance and contract status. Updates report parameters as needed.

Recounts reports per scheduled timelines; contract additions/terminations report, re-credentialing reports, and application status.

Assists in developing reports related to department tasks, department contracting efforts, templates maintenance, and ad hoc projects.

Acts as a department liaison between internal and external customers.

Responds to inquiries regarding contract status, network rosters, provider reimbursement and application/credentialing status in a timely manner.

Updates the electronic library of provider contracts for all CalOptima Health's lines of business.

Updates provider's records in the contract database.

Keeps manager and director abreast of issues and concerns of assigned contracts, projects and tasks.

Completes other projects and duties as assigned.

Experience & Education:
• Associate's degree required.
• 2 years of work experience related to managed care or related field required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

Preferred Qualifications:

Experience working with a contract management system.

Experience with SharePoint or One Note or Planner.

Experience with data analysis.

Physical Demands and Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. __

Physical Demands:

While performing duties of the job, employee may be required to move about the organization. Employee must be able to sit for extended periods of time, as well as work at the computer for long periods. Employee is required to use hands and fingers, especially for typing on the computer and using the mouse. Must also be able to reach with hands and arms and must occasionally lift office supply boxes or laptop case, up to 25 pounds. Employee must be able to communicate, particularly for regular phone use, in meetings, face-to-face interaction and while presenting.

Work Environment:

Typical office environment with minimal to moderate noise levels and controlled office temperatures.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Monday or Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima wants to have qualified employees in every job position. CalOptima prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may requ.

Read the full job description and apply online on the recuiter's web-site

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