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STAR + PLUS Provider Contract Specialist
JOB SUMMARYResponsible for network development; negotiating, monitoring and managing the contractual relationships of assigned providers. Working in coordination with Compliance, Legal, Provider Relations, and Credentialing, and under the direction of Senior Provider Contract Specialist, Manager, Senior Manager or Director, negotiates and finalizes provider contract language and rates, including amendments for existing contracts and establishment of new ones. Contracts for physician, hospital, ancillary, behavioral health, and LTSS providers for Medicaid, Health Insurance Marketplace, Medicare, and any other programs Community may develop. Responsible for provider contract compliance, including regulatory network adequac


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