Provider Contract Specialist (Contract Integrity Reviewer)
Job Description
Legal Contract Specialist - Provider ContractingPosition SummaryThe Legal Contract Specialist - Provider Contracting supports the drafting, language review, and administration of provider agreements and related healthcare contracts. This role partners closely with Legal, Provider Contracting, Compliance, and Business teams to ensure contracts are accurate, compliant, and aligned with organizational objectives.This position is ideal for a detail-oriented professional with experience in healthcare provider contracting, legal contract review, and regulatory compliance.Key ResponsibilitiesContract Drafting & ReviewDraft, review, and revise provider agreements (e.g., physicians, hospitals, ancillary providers)Ensure contract terms align with legal requirements, reimbursement structures, and organizational policiesIdentify and mitigate legal and business risks within contract languageMaintain standard templates and support updates based on regulatory or policy changesNegotiation & Execution SupportSupport negotiations with providers and third parties in collaboration with contracting and legal teamsTrack revisions, redlines, and approvals through contract lifecycleCoordinate execution of agreements and ensure completeness of documentationCompliance & Regulatory OversightEnsure contracts comply with federal and state regulations (e.g., CMS guidelines, Stark Law, Anti-Kickback Statute where applicable)Partner with Compliance and Legal teams to interpret policy changes and incorporate into agreementsAssist in audits and respond to internal/external inquiries related to provider contractsContract AdministrationMaintain contract repository and ensure accurate metadata and version controlMonitor contract expiration dates, renewals, and amendmentsGenerate reports and provide insights on contract status, trends, and risksCross-Functional CollaborationServe as a liaison between Legal, Provider Contracting, Finance, and OperationsProvide guidance to business stakeholders on contract terms and processesSupport process improvements and standardization initiativesQualificationsRequiredBachelor's degree in Business, Healthcare Administration, Legal Studies, or related field3-6+ years of experience in contract management, legal support, or provider contractingExperience reviewing healthcare provider agreements or similar commercial contractsStrong understanding of contract lifecycle management (CLM) processesExcellent written, analytical, and organizational skillsPreferredExperience in managed care, health plans, or healthcare delivery systemsFamiliarity with healthcare regulations (CMS, Medicare/Medicaid, Stark, Anti-Kickback)Paralegal certification or JD (not required but a plus)Experience with contract management systems (e.g., Ariba, DocuSign CLM, Icertis)Key CompetenciesAttention to detail and risk awarenessContract interpretation and issue spottingStakeholder communication and collaborationAbility to manage multiple contracts and deadlines simultaneouslyProblem-solving and process improvement mindsetWork EnvironmentHybrid (ideal) or remote (if applicable)Fast-paced, deadline-driven environment requiring high accuracy Apply To This Job Apply To This Job