Contract Specialist

Role Overview: 

The Contract Specialist connects our team, the health plan, and key stakeholders. This role focuses on building and maintaining collaborative relationships while ensuring contract data and documents are accurately reflected across systems. Responsibilities include hands-on contract administration, issue resolution during contract loading, and maintaining compliance standards.

Work Arrangement: Remote - Anywhere within the state of Florida. 

Responsibilities

• Build and maintain positive relationships with internal teams, health plans, and stakeholders.
• Ensure contract data and documents are accurately represented in operating systems.
• Act as a proactive contract administrator, resolving contract-related issues.
• Audit contract documents and provider records for accuracy.
• Manage and monitor Excel reports for projects and assignments.
• Create and align contract records in the contract management system with 95% accuracy.
• Monitor electronic contract files and ensure compliance with policies.
• Escalate requests that conflict with business processes or contract language.
• Support departments in investigating provider data and credentialing.
• Research and resolve discrepancies in data and documentation.
• Identify and report compliance issues.
• Maintain knowledge of Facets or other claims systems and communicate contract corrections.
• Communicate effectively and professionally with all parties.
• Collaborate with departments to execute AmeriHealth and health plan strategies.
• Perform administrative duties and attend required training sessions.
• Stay current on AmeriHealth and health plan regulations, policies, and procedures.

Education & Experience

• High School diploma or GED required; Bachelor’s degree preferred.
• 1 to 2 years of experience in provider network management, provider data management, finance operations, contract management, or contract administration within healthcare or managed care.
• Experience with contracting software (e.g., Salesforce).
• 1 to 2 years of managed care experience required.

Our Comprehensive Benefits Package

Flexible work solutions including hybrid work schedules, competitive pay, paid time off including holidays and volunteer events, health insurance coverage for you and your dependents, 401(k), tuition reimbursement, and more.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation’s leaders in health care solutions, we offer our associates the opportunity to impact on the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear from you.

Headquarters in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.