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DaVita Kidney Care

Specialist II, Contract Operations

DaVita Kidney Care

3h ago

No Phone Required$22.5 - $28.5OperationsUnited Stateshimalayas
Contract-OperationsContract-SpecialistCredentialing-SpecialistPayor-PartnershipsHealthcare-AdministrationOperations-Specialist-IIContract-Operations-AssociateContracts-SpecialistContracting-SpecialistContract-Management-SpecialistMid-level

Job Description

Posting Date06/15/20263201 S 323rd St, Federal Way, Washington, 98001-5023, United States of AmericaPosition SummaryThe Credentialing Specialist is a high-impact role within the Payor Partnerships Contract Operations team, responsible for operationalizing and maintaining contracted status for facilities connected to DaVita’s Fee For Service Agreements. This position manages a high volume of credentialing documentation, requires the ability to interpret contract language, resolve network issues, navigate credentialing obstacles with critical and innovative thinking, and navigate Contractual Lifecycle Management database for research. All while, maintaining rigorous data accuracy without direct oversight.As an Contract specialist, this teammate is expected to operate with significant autonomy, utilizing critical thinking and analytical skills to solve complex problems, manage priority payor relationships, and drive resolution on outstanding issues.Position SummaryThe Contract Specialistis a high-impact role within the Payor Partnerships Contract Operations team, responsible for operationalizing and maintaining DaVita’s Fee For Service Agreements. This position manages a high volume of complex contract reviews, requiring the ability to interpret contract language, resolve network issues, understand and provide Rate implementation guidance, navigate and populate the Contractual Lifecycle Management data base and maintain rigorous data accuracy without direct oversight.As a Contract Specialist, this teammate is expected to operate with significant autonomy, utilizing critical thinking and analytical skills to solve complex problems, manage priority payor relationships, and drive resolution on outstanding issues.*This role is 100% remote and can sit anywhere in the Continental United States.*Essential Duties & ResponsibilitiesContracting & Lifecycle Management:Accurate and timely contract reviews with regards to Best Demonstrated Performance language, check lists, codes, rates, and credentialing operational language.Issue Resolution & Critical Thinking:Independently research and resolve complex network and claims issues by collaborating with Credentialing Specialists and Negotiation teams.Analyze root causes of delays or denials using tools such as the A3 worksheet format.Assess complex situations and communicate effectively to leadership using the SBAR (Situation, Background, Assessment, Recommendation) format.Data Integrity & Reporting:Maintain accurate data across multiple systems (Orion, CLM, COR, Salesforce, and IBM-based data systems).Strong workflow communication. Provide data for weekly reports, including task categories, email volume, out of SLA task assistance and escalation tracking.Maintain an average Quality Assurance (QA) score at or above 95% for critical errors.Relationship Management:Build and maintain strong professional relationships with external payor contacts to facilitate efficient processing.Collaborate with internal " Partners" to proactively resolve account issues.Working as a collaborative team of Director, Negotiator, Credentialing Specialists, Analyst, and Team Lighthouse to provide specifically tailored Account Customer ServiceWorkload Management:Manage an extremely high volume of work, including maintaining email inbox counts below 40 and responding to requests within 1-2 business days.Prioritize tasks based on risk and value (e.g., Fee For Service Agreements, Document Reviews, Facility Status Requests, New Center Additions, Acquisitions).Resolving 90+% of all tasks within due date or assigned SLA.Manage an extremely high volume of work, including maintaining email inbox counts below 40 and responding to requests within 1-2 business days.QualificationsEducation & Experience:High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.Minimum 2 years of experience in high-volume research, Customer Accounts ownership or complex administrative resolution work.Proven track record of top performance in a production-based environment.Technical Skills:Advanced Excel Skills Required: Must have experience at the formula writing level (e.g., complex IF statements, VLOOKUP, mail merge integration, conditional formatting).Systems Proficiency: Strong proficiency in Microsoft Outlook (managing high email volume), Word, PowerPoint, and SharePoint. Experience with Salesforce or database management systems preferred.Competencies & Attributes:Critical & Analytical Thinking: Ability to analyze complex contract and credentialing scenarios and develop solutions without immediate oversight.Autonomy: Capable of working independently to solve problems; knows when to escalate issues versus resolving them personally.Resilience & adaptability: Can handle high-pressure situations, urgent deadlines, and rapid changes in payor requirements or platform technologies.Communication: Strong verbal and written communication skills; able to distill complex issues into clear, actionable update