Health Net, Inc. is a publicly traded managed care organization that delivers managed health care services through health plans and government-sponsored managed care plans. Its mission is to help people be healthy, secure and comfortable. The company provides health benefits to approximately 5.4 million individuals across the country through group, individual, Medicare (including the Medicare prescription drug benefit commonly referred to as “Part D”), Medicaid, Department of Defense, including TRICARE, and Veterans Affairs programs. Health Net’s behavioral health services subsidiary, Managed Health Network, Inc., provides behavioral health, substance abuse and employee assistance programs to approximately 4.9 million individuals, including Health Net’s own health plan members. The company’s subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.
For more information on Health Net, Inc., please visit the company’s website at www.healthnet.com.
The Contract Administrator performs administrative contract and data support procedures associated with the business operations including in-depth knowledge of business practices and procedures. Responsible for contract administration that includes updating, organizing and filing abstracts and other contractual documents for providers. Maintains files and database tracking system, prepares and distributes electronic provider updates and coordinates provider data entry.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Researches contract interpretations and drafts conclusions.
Researches contract/subcontract requirements and drafts position papers or correspondence.
Oversees accuracy and integrity of databases. Gathers data, builds/runs reports.
Maintains contract files. Maintains centralized filing system for the department and works with key customers in the retrieval and organization of data. Assembles provider contract documents and handles distribution to customers that include copies of contracts and routine contract distributions.
Identifies problems and data trends and recommends appropriate follow up. Assists in the development of desktop procedures related to data management and initiatives.
Assists in the education of data entry processes for new trainees on departmental systems and processes.
Coordinates and assists on projects.
Associate’s Degree or related technical experience; Bachelor’s degree preferred
Certification in MS applications or related database certifications preferred
Minimum three years of combined experience in contract administration, systems administration and data management
Knowledge, Skills & Abilities:
Demonstrated ability of technical expertise in systems administration
Ability to work with ITG to support the corporate technical mission and goals
Basic knowledge of financial applications
Advanced skills in PC based applications, including Microsoft Word, Excel, Access and PowerPoint, as well as database management skills and familiarity with credentialing software
Ability to work independently and as a team member to support the departmental goals
Ability to effectively plan and organize projects with heavy daily workload
Proficient data entry standard for loading and managing network contracts
Ability to organize and develop high quality reports and data within required timelines
Excellent organizational and time management skills, as well as strong attention to detail
Ability to evaluate and interpret policies and procedures
Proven ability to work with confidential data
Good interpersonal skills, as well as strong oral and written communication skills
Ability to maintain professional conduct and portray excellence and professionalism in all aspects of daily work attitude and performance
The following section describes the general physical requirements for this position. Please note that ‘constant’ refers to more than 81% of time; ‘significant’ refers to 40-80%; and ‘moderate’ refers to 20-40% of the time.
Operates personal computers, printers, facsimile, telephones, copy machines and other commonly used office accessories/equipment.
Exposed to confidential information and expected to maintain confidentiality at all times; must adhere to HIPAA rules and regulations.
May be required to work outside of normally scheduled hours as mandated by the client, project and/or workload (e.g. evenings, weekends, and/or holidays).
May be required to maintain established work pace, meet deadlines; may have last minute urgent requests.
Physical activity may include: twisting, reaching, kneeling, bending, stooping, squatting, crawling, grasping, grabbing, pushing, pulling, repetitive motion, climbing, etc.
Required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned.
Required to have hearing ability to receive detailed information through oral communication.
Required to have speaking ability to express or exchange ideas.
Constant concentration may be required on various subjects by listening, reading and thinking clearly.
Interaction with others may be required. May need to listen, think, and speak in order to interact with others. Business interactions and behavior between coworkers and/or external customers are required. This may require face-to-face or telephone interactions.
Thinking at work may include listening, learning, analyzing, evaluating, and the ability to interpret what is seen and/or heard, or to link information from one issue to the next.
Constant computer usage including typing and/or eye strain.
Constant repetitive arm, wrist, hand and finger motions — making repetitive movements (e.g. key boarding, filing, data entry).
Constant phone usage; headsets may be required.
Constant sedentary work (desk bound or seated).