Ensuring that provider contracts are compliant with current state and federal requirements and that any corrective actions assigned to the Care Management Division are completed and documented. The Specialist also assists Care Management Division operations with obtaining any needed letters of agreement (LOA) with non-contracted providers when need medical services are not readily availbe in the AHF’s provider networks.
Ensuring that its provider contracting operations are compliant with ever changing state and federal regulations and contracting documents, including provider recruitment materials are accurate and current. He or she ensures that AHF is up-to-date with contracting documents and templates. He or she, in collaboration with AHF’s IT Department, validates that provider network data submissions are error-free, which ensures compliance with state and federal network adequacy requirements and enrollee and primary care provider satisfaction.
Preferred Qualifications
AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!
Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?
If so, AIDS Healthcare Foundation is the place for you!
Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.
AHF’s core values are:
- Patient-Centered
- Value Employees
- Respect for Diversity
- Nimble
- Fight for What’s Right
Please review our Advocacy page for the latest news on how AHF is Fighting for What’s Right! Advocacy News.
Benefits at AHF
AHF offers comprehensive benefits to help our employees do and be their very best! These benefits are intended to enhance employee physical, financial, spiritual and professional health.
Skills Required
- Knowledge of state and federal provider contracting regulations
- Experience reviewing and maintaining provider contracts and contracting templates
- Ability to document and track corrective actions for Care Management Division
- Experience coordinating Letters of Agreement (LOA) with non-contracted providers
- Experience collaborating with IT to validate provider network data submissions
- Familiarity with network adequacy requirements and provider network maintenance
What We Do
Founded in 1987, the AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the United States. The organization is dedicated to providing cutting-edge medicine and advocacy regardless of a patient's ability to pay, viewing healthcare as a right rather than a privilege.
