Contract Administrator, MSO & Expansions

Job Description

Designated MSO clients & expansion markets contracting administrator. Responsible for sustaining and building assigned network with full panel of Primary Care Physicians and Specialists. Identify network needs and negotiate full agreements and Memorandums of Understandings with providers to ensure availability and accessibility for members. Produce contract documents with various reimbursement payment methodologies such as Fee for Service, Capitation, Flat rates, and Case Rates. Coordination with MSO & PMS Regional Lead(s) for designated P&L management tasks and activities.

Responsibilities

Enters specific agreements into Prospect’s Review and Approval System as requested. Reviews the legal agreement and record page for contracts entered into Prospect’s Contract Review and Approval System.

Ensures that agreements have all required attachments, supporting documents, and are consistent with system guides and contract policy(s). Ensures Record Page Types/Subtypes are accurate (affects Approval flows), fields are descriptive and accurately reflects agreement to ensure the complete package is submitted to legal counsel for review, and that the agreement follows the correct Approval flow. Escalates and resolves issues as appropriate. Ensures that exclusion checks are complete and/or provides when needed. Notifies all appropriate parties if any exclusions are found.|Ensures the fully approved agreement(s) is put into final form to prepare for signatures. Updates Record Page if any changes were made from Legal review or the Approvers. Obtains internal signatures (per authorized signatories) and assist with counterparty/vendor signature (if needed) in a timely manner. Appropriately follows up, and documents conversations when having issues obtaining countersignatures and escalates issues as appropriate.

Upon obtaining fully executed agreement, verifies the agreement is the correct agreement and updates the Record Page to reflect any outstanding fields that were affected by the contract being fully executed.

Prepares the contract file to activate. Creates/Maintains and/or update reports as needed.|Monitors expiration dates of contracts and works with business owners to ensure contract file reflects the current status of the contract terms. Follow-up on all communications regarding contracts/status (close the loop)|Manages time effectively and stays organized to ensure implementing current processes and /or direction/information. Provides additional training in system if needed. Escalates and resolves issues as appropriate.

Qualifications

Three (3) years of paralegal and/or legal support required. Strong skills in Microsoft Word, Excel, Outlook, and e-discovery platforms, with the ability to learn new programs as necessary preferred.High school degree or GEDBachelor’s Degree

LOCATION - BASED PAY ADJUSTMENT

About Us

With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.