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Current employees can apply directly through the Internal Careers Center online for Prospect Medical job openings in California. For a streamlined application process, all you need is your four-digit employee ID number and a digital copy of your résumé handy before you apply.
We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.
Negotiate Memorandum of Understanding (MOUs), maintain and update Contracting Database Application of contracted providers, act as liaison with various internal departments to facilitate and resolve claim, system, customer service and other related issues. Provide support to Provider Contracting Department.Job Responsibilities/Duties
- Negotiate and draft agreements and amendments outlining contractual terms.
- Load contracts and amendments in Contracting Database Application (CDA) and routes electronic Change Forms to implement contracts or amendments.
- Assist in Managing Claims Inquiries Box and Referral Que.
- Negotiate MOUs as needed to provide contracts for referrals to non-contracted providers and secure savings on claims for retro dates of services.
- Provide clarification on contractual arrangements to internal departments, providers and billing companies.
- Follow up for return of signed contracts, amendments or credentialing applications.
- Works with credentialing department as needed to obtain credentialing documents, upon completion of credentialing process presents contracts for execution.
- Audits CDA and Contract Summaries to ensure executed contracts are accurately entered.
- Creates and submits electronic change forms for new agreements, terminations, demographic changes, and new tax identification numbers.
- Receives calls from assigned network providers, provides customer service to network providers by responding to contracting inquiries, claim questions, credentialing issues.
- Calculate cost savings by comparing contract rates to billed charges or non-contracted rates, whichever apply.
- Documents all cost savings on the Cost Savings report.
- Outline requested contract terms and completes Financial Impact Analysis forms and submits to Decision Support to perform analysis and presents for approval.
- Supports Contract Administrators and Department by drafting contracts, updating contract summaries, updating CDA, generating reports as requested.
- Performs other duties as needed, and as assigned.
Minimum Education: Associates degree or equivalent education and experience.
Minimum Experience: Two (2) years experience in contract negotiations in the healthcare or managed services industry.
Req. Certification/Licensure: None.Employee Value Proposition
Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:
- Company 401K
- Medical, dental, vision insurance
- Paid time-off
- Life insurance
Prospect Medical Systems has a zero-tolerance policy regarding the use of drugs and alcohol. Our Company is committed to maintaining a productive, drug free workplace that keeps employees and patients safe from harm. For this reason, we require applicants to pass a screening for drug use as a condition of employment. This includes: alcohol, marijuana, cocaine, opiates and methamphetamines.How to Apply
To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.
EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm
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