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Job Posting Title Provider Contracting Specialist Agency 807 HEALTH CARE AUTHORITY Supervisory Organization EGID Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Estimated Appointment End Date (Continuous if Blank) Full/Part-Time Full time Job Type Regular Compensation $22.81875 / Hourly Why You’ll Love Working Here At the Oklahoma Health Care Authority (OHCA), your work matters. Every day, our team helps ensure Oklahomans have access to better health and better care. Guided by our core values, Passion for Purpose, Trust & Transparency, Empowerment & Accountability, Best-in-Class, Outcome-Driven, and Servant Leadership , we foster a workplace where people feel supported, respected, and empowered to make an impact. Learn more about OHCA. Let’s Talk Benefits We know your great work deserves great support. Here’s a snapshot of what we offer for all eligible employees. • Generous state-paid benefit allowance to offset insurance premiums. • A wide selection of insurance plans with no pre-existing condition exclusions. • Flexible Spending Accounts for health care and dependent care. • Retirement Savings Plan with employer contributions. • 11 paid holidays annually. • 15 days of vacation and 15 days of sick leave in the first year. • Longevity Bonus recognizing years of public service. • Public Service Loan Forgiveness eligibility and tuition reimbursement. • Wellness benefits, including an on-site gym and fitness center discounts. Job Description Location: 4345 N Lincoln Blvd, Oklahoma City, OK 73105 Salary: $22.81875 / Hour Work Schedule: Monday – Friday Primary Hours: 8:00 a.m. – 5:00 p.m. Agency/Division Information The Oklahoma Health Care Authority (OHCA)   works to ensure Oklahomans have access to better hea l th and better care.   The agency’s core values include passion for purpose, trust and transparency,   empowerment   and accountability, best in class and outcome-driven, and servant leadership.   As part of the interview process, candidates may   be required   to attend an in-person interview at our Oklahoma City office. Position Purpose The Provider Contracting Specialist  is responsible for  managing provider   contracts,  maintaining  provider relationships, and ensuring compliance with applicable   regulations and policies. This role includes handling incoming and outgoing   communications,  maintaining   accurate  provider data, and supporting provider network   management activities to ensure efficient and effective service delivery. Essential Functions   May Include : • Ensure  accurate  and  timely  management of provider contracts, including pricing NSA claims, negotiating NSA requests, and responding to independent dispute resolutions. • Foster strong working relationships with providers through effective communication,  timely  response to inquiries, and proactive resolution of issues. • Adhere to HIPAA regulations, OMES policies, and other relevant statutes by protecting the privacy and confidentiality of program participants' information. • Enter and review provider demographics accurately and  timely , ensuring an accuracy rate of 97% or better based on audits. • Handle incoming and outgoing calls, emails, and provider retention tasks while  maintaining  a customer service quality audit score of 85% or better. • Other duties as assigned. Knowledge,   Skills, /   Abilities and Competenc y Requirements This position requires knowledge of provider contracting, health insurance operations, reimbursement methodologies, claims processes, regulatory requirements, and provider database maintenance. The successful candidate must   demonstrate   strong organizational, analytical, customer service, written and verbal communication, negotiation, and problem-solving skills, with the ability to manage multiple priorities,   maintain   accurate   and confidential information, interpret contract provisions and policies, and build effective relationships with providers and internal partners. Key Korn Ferry competencies include Ensures Accountability, by consistently meeting accuracy, quality, and timeliness standards; Communicates Effectively, by providing clear, responsive, and professional communication; and Manages Complexity, by evaluating detailed contractual, regulatory, reimbursement, and provider-related information to resolve issues and support effective network operations To be considered for this position your application must include a resume/CV with complete work and education history. Education and/or Experience: • A bachelor’s degree and 2 years of experience in health insurance benefit administration or health care industry provider contracting   OR • An equivalent combination of education and experience. Preference Qualifications Include : • Knowledge of Medicare guidelines policies and procedures. • Knowledge of provider licensing, certification, contractual issues, reimbursement, procedural coding, benefit  coverage  and liability requirements. Knowledge  regarding  these laws, regulations and procedures   are   critical to the management of an effective Provider Network. • Knowledge of provider database maintenance, plan provisions, agency policies, provider types, credentials management, coding and reimbursement methods, claims payment process, and contract provisions/terminology. • Strong organizational skills. • Knowledge of large group network management and provider services to include provider enrollment and contracting, verbal and written communication skills, customer services and experience providing phone coverage, provider recruitment, training, response to member and provider inquiries, use of network database applications • Requires a detailed understanding of insurance plan provisions, terms, policies,   provider types, credentials management, coding and reimbursement methods, claims payment processes, contract  provisions  and terminology. • Knowledge of and ability to use Microsoft Office Applications. Physical Demands and   Work Environment Work is typically performed in an office setting with climate-controlled settings and exposure to   moderate noise levels.   In the course of   performing job duties, employees   are required to   speak, stand, walk, and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position. Accommodation Statement The Oklahoma Health Care Authority   complies with   applicable State and 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. Notice to applicants : Please add [email protected]   to the address book or “safe-senders” list in your email.  All correspondence will come from this address.  Be sure to check your junk folder.  If you have questions about the status of your application, you can contact the HR team at 405-522-7093. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Current State of Oklahoma employees must apply for open positions internally through Workday  Jobs Hub . Equal Opportunity Employment The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability. Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub . If you are needing any extra assistance or have any questions relating to a job you have applied for, please click the link below and find the agency for which you applied for additional information: Agency Contact