About Our Company
At Altais, we're looking for bold and curious clinicians and innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, advanced care providers, patients, and the clinical community. At Altais, we're building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.

About Your Team

Are you looking to work with a high performing, fast growing and dynamic Contracting team? We are 4,000+ physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.

About Your Work

The Payer Contract Specialist has responsibility for day-to-day managed care operations from a payer contracting and workflow perspective. The position is involved in planning, development of tools and resources, implementation of contract requirements, and reporting for each assigned health plan. This position works cross functionally with all other departments including, medical management, finance, claims, physician relations, customer services and IT to achieve market goals and objectives. This position will work closely with payors to develop open, strategic relationships. You'll be part of a performance driven, fast paced organization that is serving multiple markets and you'll be assisting and maintaining a production-based team to meet aggressive goals.

You will work hybrid in anywhere in the continental United States, and you are willing to work on California hours from approximately 9:00am to 5:00pm Pacific Time.

You will focus on:

• Participates in operational planning for the health plan payers and facilitates the execution of the plan through Joint Operation Committee meetings. Responsible to schedule annually, maintain current attendee list, coordinate agenda items and meeting minutes with all internal stakeholders.
• Assist in the preparation and review of contract documentation by checking for accuracy and analyzing contract terms and history.
• Document Maintenance; routing documents for signature, tracking necessary signatures, uploading into database.
• Gather, distribute, and electronically file all health plan correspondence.
• Create and maintain tools and resources for all Altais entities; i.e. health plan contact lists, member block transfer grid, service area grid, product grid.
• Maintain internal Sharepoint site with payer documents; i.e. DOFR's, delegation agreements, provider manuals
• Contract language grid creation and maintenance; i.e. offshore language
• Maintains effective network support services by working effectively with the Physician Relations, Medical Services, Claims, and other internal operational departments.
• Handles complex and/or difficult payer inquires and/or problems and facilitates resolution of issues.
• Active participation in internal organization projects as a representative of the Contracting department, and any other adhoc projects.
• Continuously strive to ensure that favorable relationships are maintained while ensuring the interest of the organization.
• Drives change and innovation through continually seeking and implementing value added solutions for efficient workflows, automation, and
• Communicate and advocate to internal stakeholders to drive creation of solutions that meet our mutual business goals.
• Analyzes data while collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues.
• Performs all other related duties as assigned.

The Skills, Experience & Education You Bring

• Minimum 3-5 years of managed care experience without a Bachelor's degree
• Minimum of 3 years of managed care experience
• Experience with an emphasis on network management, managed care operations, and health plan or medical group contracting.
• Experience in health plan contract negotiations and/or provider relations experience is preferred.
• 1+ years of experience with health care contract language review.
• Knowledge of various risk types, delegation, DOFRs, provider manuals, and lines of business/health plan products
• Preferred: Knowledge of Medicare and Medicaid regulations. Experience in MSO databases, i.e. Symplr, Epic, IDX, EZ-Cap

You Share our Mission & Values

• You are passionate about improving the healthcare experience and want to be part of the Altais mission.
• You are bold and curious- willing to take risks, try new things and be creative.
• You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
• You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
• You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
• You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.

Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate's starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate's qualifications, skills, and experience.

Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our 'CPRA Privacy Notice for California Employees and Applicants' to learn how we collect and process your personal information when you apply for a role with us.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of workday.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.