Agency/Division Information

The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office.

Position Purpose

The Provider Contracts Analyst IV is responsible for providing strategic oversight and leadership in managing provider contracts and ensuring compliance with regulatory requirements. This position involves screening potential providers, processing data changes, and monitoring licensure to maintain database integrity. Additionally, the role supports complex contracting inquiries, identifies areas for improvement, and ensures the effectiveness of contracting processes. As a key point of contact and team leader, the Provider Contracts Analyst IV mentors staff and collaborates with internal and external stakeholders to meet the agency's operational and strategic goals.

Essential Functions May Include:

• Oversees complex provider contract administration activities to ensure compliance with OHCA policies, Medicaid regulations, and contractual requirements.

• Serves as a lead resource for complex provider contracting issues, escalations, and inquiries requiring advanced policy interpretation or coordination across divisions.

• Reviews and resolves complex provider enrollment, credentialing, and contract issues while ensuring accuracy and timeliness of provider records.

• Monitors provider licensure, contract status, and enrollment data to ensure compliance with state and federal requirements and maintain database integrity.

• Coordinates with internal teams such as policy, IT/system support, and operations to resolve systemic contracting or enrollment issues.

• Provides guidance and technical support to Provider Contracts Analysts and other staff on contracting procedures, provider policies, and system processes.

• Assists in developing and updating procedures, training materials, and standard operating documentation related to provider contracting activities.

• Evaluates contracting workflows and operational processes to identify inefficiencies, compliance risks, or opportunities for improvement.

• Participates in implementing process improvements, system updates, or policy changes that affect provider contracting and enrollment operations.

• Tracks and analyzes trends in provider inquiries, contract issues, or operational challenges and provides feedback or recommendations to leadership.

• Serves as a point of contact for internal stakeholders and external partners regarding complex provider contracting matters.

• Other duties as assigned.

Supervisory Responsibilities: This position does not supervise.

Knowledge, Skills, Abilities and Competency Requirements

This position requires in-depth knowledge of agency policies, state and federal legislation, and principles of program administration. Strong skills in communication, problem-solving, and collaboration are essential to maintain relationships and resolve complex contracting issues. The ability to manage multiple priorities, provide leadership, and align programs with broader organizational goals is critical. The Korn Ferry competencies of Ensures Accountability and Manages Complexity closely align with this role, as they involve overseeing provider compliance and improving contracting processes while managing operational challenges.

Education and/or Experience:

• A bachelor's degree and 1 year of professional or technical administrative experience in business or public administration OR

• An equivalent combination of education and experience, substituting 1 year of qualifying experience for each year of the required education.

• Technical administrative experience would include highly complex clerical work gained under the direct supervision of a professional supervisor or manager.

Preference Qualifications Include:

• Certifications in any of the following areas: Certified Provider Credentialing Specialist (CPCS), Certified Healthcare Contracting Professional (CHCP), Project Management Professional (PMP), Lean Six Sigma Green Belt or Black Belt, Compliance Certification

• Legal or Regulatory Licenses

• Experience in Medicaid/Medicare Regulations

Physical Demands and Work Environment

Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels. In the course of performing job duties, employees are required to speak, stand, walk, and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position.