Davita

SpecialistII,ContractOperations

$0–0k 09507 - Colorado Remote FULL TIME Remote Friendly
The Brief

“Specialist II, Contract Operations at Davita. Skills: Contract operations, Payor partnerships, Data integrity. Review contracts for Best Demonstrated Performance language. Review contracts for check lists”

What You'll Achieve.

Maintain an average Quality Assurance (QA) score at or above 95%; Resolving 90+% of all tasks within due date; Resolving 90+% of all tasks within assigned SLA

Industry & Context.

Problems you'll solve

Critical thinking; Analytical skills; Solve complex problems; Root cause analysis; Troubleshooting

What They're Looking For.

Must Have

High school diploma or equivalent, Minimum 2 years of experience in high-volume research, Minimum 2 years of experience in Customer Accounts ownership, Minimum 2 years of experience in complex administrative resolution work, Advanced Excel Skills Required, Proficiency in Microsoft Outlook, Proficiency in Microsoft Word, Proficiency in Microsoft PowerPoint, Proficiency in Microsoft SharePoint

Nice to Have

Associate’s or Bachelor’s degree preferred, Experience with Salesforce preferred, Experience with database management systems preferred

What You'll Do.

Review contracts for Best Demonstrated Performance language

Review contracts for check lists

Review contracts for codes

Review contracts for rates

Review contracts for credentialing operational language

Research complex network issues

Resolve complex network issues

Research claims issues

Resolve claims issues

Analyze root causes of delays

Analyze root causes of denials

Assess complex situations

Communicate to leadership

Maintain accurate data across systems

Provide data for weekly reports

Maintain an average Quality Assurance score at or

Build professional relationships with external payor contacts

Maintain professional relationships with external payor contacts

Collaborate with internal Partners

Resolve account issues

Work as a collaborative team

Provide tailored Account Customer Service

Manage high volume of work

Maintain email inbox counts below 40

Respond to requests within 1-2 business days

Prioritize tasks based on risk

Prioritize tasks based on value

Resolve 90+% of all tasks within due date

Resolve 90+% of all tasks within assigned SLA

How You'll Work.

Team & Collaboration

Collaborating with Credentialing Specialists; Collaborating with Negotiation teams; Collaborate with internal Partners; Collaborative team of Director; Collaborative team of Negotiator; Collaborative team of Credentialing Specialists; Collaborative team of Analyst; Collaborative team of Team Lighthouse

Communication Scope

Communicate effectively to leadership; Verbal communication; Written communication; Distill complex issues

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