Provider Contracts Analyst III

Recruitment #220629-UNCE-379

Introduction

This position is open ONLY to OHCA Staff and/or Contractors.

Provider Contracts Analyst III

POSITION REQUIREMENTS:
This position is responsible for handling all state and federally required screening and processing of applications of Medicaid providers for the purposing of establishing a SoonerCare provider network.

PRINCIPLE ACTIVITIES: 
- Screen all potential providers through numerous federal and state databases, advancing provider applications to enable payment between OHCA and providers.
- Maintain timelines on enrollment/credentialing schedules and provide customers (both internal and external) with status updates.
- Monitor provider licensure, malpractice insurance and DEA/OBN expirations.
- Ensure provider database integrity and verify compliance with system, legal, and policy requirements for all provider contracts.
- As OHCA implements new programs, identify new provider file requirements and work with staff to develop new operating procedures to accommodate new programs and requirements; may write operating procedures; may train staff in new procedures
- Monitors provider contracting processes and data and ensures transactions are completed in accordance with unit operating procedures, agency policy, and state and federal guidelines.
- Identify complex problem areas within MMIS and report issues accordingly and in regard to the telephone response system; make recommendations to achieve overall improvements.
-  Participates in OHCA provider call center as well as respond to email and fax inquiries. Answers a wide variety of questions and resolves problems related to contract requirements, licensing, disclosure of ownership, and electronic funds transfer. Some questions require research and independent judgement. Other duties as assigned.

TRAVEL:  This position has no travel responsibilities.

Accommodation Statement:
The Oklahoma Health Care Authority complies with applicable Federal civil rights laws and does not discriminate.  All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at 405-522-7335.

 

MINIMUM QUALIFICATIONS

KNOWLEDGE AND BACKGROUND REQUIREMENTS
QUALIFICATIONS
: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. 
The requirements listed below are representative of the knowledge, skill, and/or ability required. 

EDUCATION AND/OR EXPERIENCE:
- Bachelor’s degree OR
- Four (4) years of experience in provider contracts and/or Medicaid OR
- Equivalent combination of education and experience equal to 4 years

PREFERENCE MAY BE GIVEN TO CANDIDATES WITH:
- OHCA employee or OHCA contractor employee
- MMIS experience

NOTES

Please read instructions carefully and include all required documents when you submit your application.

No additional information will be accepted after the application has been submitted.