COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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Contract Specialist II

  • Job ID: 622507958
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Hospital Reimbursement
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $21.60 to $36.02 / hour

Description

UPMC Health Plan's Hospital Reimbursement department is looking for a Contract Specialist II. This is a full-time position that will work standard daylight hours Monday through Friday. The team is based out of downtown Pittsburgh's US Steel Tower. This position will predominately work remotely but will eventually return to the office in a hybrid structure. 

The Contract Specialist II is responsible for facilitating a seamless process from the time a provider is identified as needed in the network to contracting with the provider for services. The Contract Specialist II reviews any alterations in the status of contracted providers that may impact on their ability to continue to be in the provider network including changes in license, certifications, Medical Assistance enrollment and completing precedential requirements. Maintains the contract files for all provider types.

Responsibilities:

 

  • Coordinate the addition of new provider demographic information into UPMC Health Plan systems.
  • Respond to inquiries regarding provider network from other internal departments such as Marketing and Government Programs.
  • Assemble binders for Department of Health and DPW filings.
  • Review provider rosters, request missing information if applicable, and submit completed roster to configuration team.
  • Coordinate provider file changes with the provider information department.
  • Custodian for all Network and Vendor Relations Contract Files.
  • Assure that provider contracts are fully executed by both parties and that contract copies are filed.
  • Provide support to the Network and Vendor Relations Department by responding to inquiries from internal and external customers.
  • Coordinate mailing to providers relating to new contracting issues or contract changes.

 

Qualifications

  • Bachelors degree and 3 years relevant experience
  • OR 7 years of equivalent work experience required (contract experience preferred)
  • Thorough knowledge of NCQA standards and other relevant external quality standards.
  • Knowledge of state and federal standards for contracting.
  • Knowledge of Provider Types.
  • Knowledge with experience in contracting with providers for services.
  • Excellent written and oral communication skills.
  • Ability to work independently and to analyze complex situations accurately and in a timely manner.
  • General knowledge of managed care functions and management techniques preferred.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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