PACE Contracts Specialist (29577)

PACE Contracts Specialist

General Purpose

Under limited supervision, the PACE Contracts Specialist oversees the development, implementation, and management of contracts supporting PACE operations. This position manages provider and contractor relationships, ensures regulatory compliance, and supports network development and credentialing activities.

Essential Duties & Responsibilities

• Manage contracted service agreements and provider/contractor relationships.
• Support provider recruitment and network development with leadership and the Medical Director.
• Coordinate contractor onboarding, credentialing, renewals, and compliance activities.
• Maintain contract, credentialing, and provider databases and electronic filing systems.
• Monitor compliance with CMS, DHCS, OIG, NPDB, HIPAA, FWA, and other regulatory requirements.
• Generate reports related to training, renewals, and compliance tracking.
• Assist with contractor agreements, reimbursement analysis, and rate-setting support.
• Perform additional administrative, finance, and compliance duties as assigned.

Qualifications

• Bachelor's degree required; Paralegal certification preferred.
• Valid California Driver's License required.
• Minimum five (5) years of healthcare contracting experience in a managed care environment required.
• Experience in provider contracting, credentialing, provider relations, and compliance preferred.
• Strong knowledge of Medi-Cal, Medicare, Medicare Advantage, and managed care contracting.
• Proficient in Microsoft Office programs and database management systems.
• Strong communication, organizational, and analytical skills.

Working Conditions & Physical Requirements

• Primarily office-based environment.
• Must be able to lift up to 40 lbs. and push up to 100 lbs. on wheels.
• Requires sitting, standing, bending, reaching, and manual dexterity throughout the workday.