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The Contracts & Audits Specialist contributes to AHF by ensuring that provider contracts are compliant with current state and federal requirements and that any corrective actions assigned to the Contracting and Provider Relations Department 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 needed medical services are not readily availabe in the AHF’s provider networks.

The Contracts & Audits Specialist enhances the reputation of AHF by 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.

You will be a passionate advocate for our top initiatives.

To be successful as the Contracts & Audits Specialst, it is crucial to ensure that the AHF Core Values and Mission stay top of mind with all that you do. At AHF, we are nimble and able to adapt in a dynamic environment to assist in providing the best experience for our clients and workplace for our employees.

AHF has a collaborative organizational structure where staff are accountable to multiple leaders.

The Contracts & Audits Specialist will work as a part of a close-knit team to ensure that the Contracting and Provider Relations operation is compliant with state and federal mandates.