Hoag

Nonprofit regional health care delivery system

Contract Specialist: Managed Care Contracting

Contract ManagementPosted on Nov 10

Full-timeCosta Mesa, CA, USA$34.07 - $50.54 /hrIn-person

About the Job

Requirements

High school diploma and three years of experience in an office setting; experience in health care or managed care is preferred.
Understanding of health insurance plans, including HMO and PPO plans.

Responsibilities

Maintain the Hoag Network contracting process for the Managed Care Contracting Department.
Distribute all new and amended PPO, HMO, and ancillary agreements to internal and external stakeholders as applicable.
Maintain and test Hoag Network contracts in EPIC.
Audit contract reimbursement terms and work with payors to address reimbursement issues.
Maintain contract files and online access to contracts and various databases.
Coordinate the flow of contract documents for signature throughout the organization.
Communicate contract information to internal and external customers.
Provide administrative assistance as needed.

Desired Qualifications

Two years of college.

Primary Duties and Responsibilities

Maintains the Hoag Network contracting process for the Managed Care Contracting Department.
Distributes all new and amended PPO/HMO/Ancillary agreements to internal/external stakeholders as applicable.
Responsible for the ongoing maintenance and testing of Hoag Network contracts in EPIC.
Responsible for ongoing audits of contract reimbursement terms working with payors to address all reimbursement issues.
Maintains contract files and online access to contracts and various databases, coordinates flow of contract documents for signature throughout the organization, communicates Contract Information to internal and external customers, provides administrative assistance if needed.

Education and Experience

High School diploma and three years experience in an office setting, preferably in health care or managed care.
Understanding of health insurance plans (HMO, PPO, etc.)
Two years of college preferred

License Required

N/A

License Preferred

N/A

Certifications Required

N/A

Certifications Preferred

N/A

Pay Range: $34.07/hour to $50.54/hour

About the Company

Hoag

Nonprofit regional health care delivery system

Hoag is a nonprofit regional health care delivery system in Orange County, California, delivering comprehensive, personalized care through 1,800 physicians, 17 urgent care facilities, 12 health and wellness centers, and two hospitals. It operates seven institutes focused on cancer, digestive health, heart and vascular, neurosciences, spine, women’s health, and orthopedics (via Hoag Orthopedic Institute, including an orthopedic hospital and four ambulatory surgical centers). Hoag is the highest ranked hospital in Orange County by U.S. News & World Report and the only OC hospital listed in California’s Top 10, and it holds Magnet designation from the American Nurses Credentialing Center. Its model combines prevention, specialty care, surgery, and coordinated services to meet local health needs. Hoag’s goal is to provide world-class, accessible, patient-centered care that improves health outcomes for the communities it serves.

Company size: 1,001-5,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Newport Beach, CA
Founded: 1952

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