Provider Network Relations Representative

Elite Technical is seeking a Provider Network Contracting Representative in the Maryland/Washington DC area. The selected candidate will perform a variety of administrative functions and coordination in support of the provider contracting process and initiatives. Responsible for responding to complex and escalated contracting inquiries from a variety of network providers and care partners related to Medicare, Medicaid, Commercial and DSNP contracts. Assists functional teams daily to ensure all requests are handled in a timely and customer focused, professional manner.

ESSENTIAL FUNCTIONS:
-- 35% Manage Contracting email boxes. Works with the appropriate leader to triage and respond to complex and escalated inquiries from external provider practices or health care entities, as well as internal requests and bring to resolution in a timely manner, or escalate to an accountable party. Follows up to ensure resolution and/or assists with tasks to support resolution.
-- 30% Supporting and organizing contracting related workflows including but not limited to: Carrying out ad hoc mailings, uploading and printing of contracts, updating fee disclosures, editing/updating templates, gathering documentation for audits or other regulatory requirements, researching returned mail and triaging complaints/inquires.
-- 15% Update and maintain supporting documentation, process and standard operating procedures for the department. Provides regular updates to management with regard to identified and outstanding issues or trends.
-- 10% Maintain in-depth knowledge insurance plans, product offering and reimbursement models. Stays abreast of changes and trends in Health Care.
-- 10% Other duties related to provider contracting and networks management as assigned.

Required Skills

- HS Diploma or GED is required
- Minimum of 3 years of Provider Relations/Network Contracting experience. Open to candidates that come from either the Provider and Payor sides of Healthcare organizations.
- Must have experience interacting and building relationships with Providers regarding Contracts, both video and phone
- Technical Skills: MS Word, Excel and Outlook

Pluses:
- Medicare/Medicaid
- Coupa (contract mgt system)
- DocuSign (for contract sending)

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Location

Hybrid/Canton, MD

Openings

2

Anticipated Start Date

Monday, May 19, 2025

Job Type

Contract

Anticipated Duration

9 months+

Date Posted

Thursday, April 24, 2025

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Elite Technical Services, Inc. participates in the E-Verify program to confirm the employment eligibility of all persons hired. This means that we will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee's Form I-9 to confirm work authorization. Elite Technical Services, Inc. will not use E-Verify to pre-screen job applicants.

Elite Technical Services, Inc. is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.