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Supervisor, Contract Management System

Description

UPMC Health Plan is hiring a full-time Supervisor, Contract Management System to support the National Network Management department. The team is based out of downtown Pittsburgh's US Steel Tower, however, this position will primarily work remotely with in-office attendance required twice per month. 

The Supervisor, Contract Management System is a mid-level provider network supervisory position responsible for assisting the department manager with maintaining all provider data, including contracts of the UPMC Health Plan network of health care providers, as well as supervising the Contract Specialists. The incumbent will also assist with implementation of the strategic plans to improve the maintenance of provider data. The Supervisor, Contract Management System will be responsible for coordinating all aspects of provider data maintenance, including coordination with other departments for reporting and providing network data.

Responsibilities:

 

  • Lead all special projects and work with staff responsibilities as necessary to ensure active participation and completion including: the provider termination process, the Provider Data File Cleanup Process, monitoring provider data loads.
  • Oversee daily responsibilities for Contract Specialists and temporary employees. Coordinate with other staff on special projects as necessary. Assign workload to team members through PNI service account.
  • Responsible for executing contracts within SalesForce and monitoring the contract transfer process into FileNet.
  • Assist with audits and necessary reports, and implementation of any area of opportunity.
  • Oversee Provider data maintenance process including Provider OnLine changes, Provider Network Inquiries mailbox, provider application process and contract requests, and process network requests/denials.
  • Work with Credentialing Dept. to insure proper application processing and disbursement of new provider additions to the network. Perform employee performance reviews and conduct monthly check-ins with direct reports. Review and sign off on Payroll. Oversee onboarding of delegated entities including completion of amendment, review/implementation of provider data files. Assist management in approval of provider terminations.

 

Qualifications

  • Bachelor's Degree in health care administration, business and/or other related discipline (Related experience may be substituted for educational requirements).
  • A minimum of 5 years of applicable experience in health care insurance or health care delivery is required with at least 2 years in network contracting and provider data maintenance activities is required.
  • Candidate must also demonstrate leadership and project management skills.
  • Candidate must demonstrate excellent written and oral communication skills.
  • Must be able to interact with hospital executives, physicians and practice managers.
  • Excellent planning, documentation, organizational, analytical and problem-solving skills are also required.
  • Strong computer skills.
  • Ability to re-engineer processes to positively impact productivity in terms of timeliness and accuracy.
  • Ability to develop, maintain and communicate status updates and reports on success of network contracting and provider data maintenance activities.


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UPMC is an Equal Opportunity Employer/Disability/Veteran

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