Job Description

Contracting and Compliance Specialist

Who we are

Health Rosetta has the audacious mission to fix our broken health care system. We build the blueprint for high-performance health benefits plans, using a practical approach based on what successful purchasers do. We drive its adoption by growing an emerging ecosystem and building technology and services to simplify adoption, creating a LEED-like blueprint. The Health Rosetta framework constantly evolves to include deeper insights and emerging approaches, creating components, case studies, data, and best practices sourced from experts and practitioners. We build the Health Rosetta into a platform of technology and supporting services that simplify architecting, implementing, and optimizing Health Rosetta-centric plans. Overwhelming demand for this platform is why we need you.

Job Description

The contracting and compliance specialist works to ensure employer sponsored self-funded healthcare agreements and plan contracts are set up appropriately to mitigate risk for our employer clients. In addition, streamline the process of setting up standard checklists, agreements and language with various healthcare administrative vendors including: pharmacy, third-party administrators, provider contracting, stop-loss and other plan vendors. Typical agreements that you will be dealing with on a day-to-day basis in the self-funded employer space are vendor agreements, stop-loss contracts and policies, administrative services agreements, summary plan documents, Business Associate Agreements, Non-Disclosure Agreements, Pharmacy Benefit Management Contracts, provider contracts, and more. You will work closely with the Health Rosetta team and our attorneys to create, maintain and identify standards for all agreements to streamline and mitigate risk for all of our client’s employer-sponsored self-funded health plans.

Duties:

  1. Develop processes and resource materials for service agreements, contracts and plan document reviews
  2. Use checklists to review service agreements, contracts and plan documents for specific terms and language’
  3. Maintain checklist processes ensuring they are the most current and best standards available
  4. Review vendor agreements to identify appropriate language and standards
  5. Review vendor agreements on an annual basis to make any improvements in language and process on behalf of Health Rosetta clients
  6. Support and perform embedded solution (vendor) reviews to ensure that they are meeting commitments and identifying any improvements in standards and process
  7. Act as a liaison between our expert services team, legal and our Clients
  8. Review provider agreements
  9. Develop subject matter expertise in one or more areas that benefit Legal, compliance and/or provider agreements
  10. Participate in developing internal guidelines, standard operating procedures, checklists, knowledge articles and packaged knowledge capital on various legal and business issues

Required Experience:

Three or more years of experience to include interpretation of state and/or federal statutes and regulations including two or more years of legislative/regulatory environment and regulatory compliance experience specifically with HIPAA and Federal/State privacy laws.

Preferred Experience:

  1. Technical Writer experience
  2. Provider contracting experience
  3. Project Management background

Supervises:

No direct supervisor responsibilities

Skills:

  1. Strong communication skills, excellent at interpreting and translating complex detail to a basic level of detail for someone not familiar with the industry
  2. Analytical, able to identify performance trends
  3. Presenting information, able to communicate with all levels of the organization, clients and partners
  4. Process improvement, recommend and execute ongoing improvements to product and process.
  5. Strong initiative, is able to pursue work in uncertain conditions

Application Process

  • Submit a cover letter and resume to careers@healthrosetta.org. Your cover letter must include 2-5 sentence answers to each of the “What we’re looking for” questions. Applications which do not include those will not be considered.
  • Extra credit: Send with your cover letter: Download the Opioid Crisis Wake-up Call. Read the Rosen Hotel Case Study and Chapter 21 Value-based Primary Care. Create a list of resources needed and steps to follow to present and implement VBPC at a 300 person manufacturing plant. (We’re looking for how you approach it, not perfection. Aim for 30 minutes to read and 30 minutes to rough out an outline that helps us understand your thought process).

Equity Statement

We strive to create an equitable and just workplace that reflects the communities we serve and where everyone feels safe and supported to bring their full, authentic selves. Equal employment opportunity and having a diverse staff are fundamental principles of Health Rosetta, where employment and promotional opportunities are based upon individual capabilities and qualifications without regard to race, color, religion, gender, gender identity or expression, pregnancy, family status, sexual orientation, age, national origin, marital status, citizenship, disability, veteran status or any other protected characteristic as established under law. We encourage candidates from diverse backgrounds including BIPOC (Black, Indigenous, and People of Color) folks, people who are LGBTQIA+, and people with disabilities to apply and join us in our work. We strive to create an equitable and just workplace that reflects the communities we serve and where everyone feels safe and supported to bring their full, authentic selves. Equal employment opportunity and having a diverse staff are fundamental principles of Health Rosetta, where employment and promotional opportunities are based upon individual capabilities and qualifications without regard to race, color, religion, gender, gender identity or expression, pregnancy, family status, sexual orientation, age, national origin, marital status, citizenship, disability, veteran status or any other protected characteristic as established under law.

We encourage candidates from diverse backgrounds including BIPOC (Black, Indigenous, and People of Color) folks, people who are LGBTQIA+, and people with disabilities to apply and join us in our work.