Plume is a mission-driven, trans-founded company focused on radically increasing access to healthcare for the transgender and gender-nonconforming communities. Our vision is to transform healthcare for every trans life and build a virtual care home for the trans community. As a rapidly expanding organization, we are now proudly available to more than 1 million transgender individuals in 45 states. We are an organization formed through the lived experience of trans people and fierce allies, and we welcome other heart-forward, talented individuals to join our team on this journey.
If you share our mission and values, possess experience as a Payer Contracting Coordinator with a background in Credentialing and Contracting, and have a deep understanding and affinity for the trans experience, we encourage you to continue reading!
About the Role:
The Contracting Associate role is a vital position within our Credentialing and Contracting team, entrusted with overseeing all aspects of payer contracting lifecycle. Your deep passion for supporting the underserved trans community and eagerness to play a crucial role in broadening access to care are invaluable.
This role is a key part of our fee-for-service reimbursement strategy, offering a unique opportunity for motivated individuals to make an immediate and significant impact. As a Contracting Associate, you’ll be at the forefront of developing and executing our payer contract management initiatives, playing an integral role in fostering strong payer relationships and managing contracts efficiently, contributing significantly to the operational success of our organization. If this sounds like the right challenge for you, we encourage you to apply and join us in making a difference.
Responsibilities
- Build and maintain strong relationships with payer partners.
- Advocate for organizational interests and collaborate for mutual success.
- Drive performance improvement initiatives with internal teams and payer partners.
- Maintain and update contract rates, including yearly governmental changes.
- Identify payment discrepancies and market trends to optimize collections.
- Assist in negotiating with payers for rate increases, as required.
- Assess initial contract terms for Operations and Finance.
- Review and summarize contract amendments.
- Coordinate document submission for new payer contracts.
- Communicate new payer developments to relevant departments.
- Manage payer dashboard access for new hires and terminated employees.
- Analyze contracts, identify improvement areas, and suggest changes.
- Assist in developing payer contracting strategies.
- Ensure compliance with laws, regulations, and policies.
- Work across departments to solve contract/credentialing issues.
- Undertake other duties as required for organizational support.
About You
- Relevant Experience and Skills:
- Proven track record in payer contracting and provider credentialing, with at least two years of experience.
- Manage the research, preparation, and submission of contract applications, including credentialing and enrollment forms as required by plans. Diligently track and report on the progress of each submission.
- Familiarity with various insurance plans and healthcare payment systems.
- Proficiency in managing relationships with insurance payers.
- A proven passion for and affinity with the mission of Plume, to transform healthcare for every trans life
- Knowledge of Healthcare Regulations:
- Understanding of healthcare regulations, including HIPAA, and federal and state laws.
- Familiarity with the specifics of credentialing standards and processes.
- NCQA knowledge is a plus.
- Strong Communication Skills:
- Ability to effectively communicate with various stakeholders, including insurance representatives, healthcare providers, and team members.
- Skilled in both written and verbal communication.
- Analytical and Problem-Solving Abilities:
- Aptitude for analyzing contract terms, reimbursement rates, and fee schedules.
- Ability to identify and resolve discrepancies and issues in payer contracts.
- Organizational Skills:
- Strong organizational and time-management skills, with an ability to prioritize tasks effectively.
- Cultural Competency and Sensitivity:
- Demonstrated understanding and empathy towards the trans experience.
- Commitment to inclusivity and respectful communication.
- Educational Background:
- A degree in healthcare administration, business, or a related field.
- Certifications related to healthcare contracting or credentialing can be a plus.
- Technology Proficiency:
- Familiarity with healthcare IT systems, credentialing databases (Salesforce), and GSuite.
- Adaptability and Continuous Learning:
- Ability to adapt to a changing healthcare landscape.
- Commitment to staying updated on industry trends and best practices.
- Ability to work collaboratively within a team, contributing positively to team dynamics.
$57,000 – $64,000 a year