Managed Care Contract Analyst

This is a fully remote position, open to applicants in South Carolina.

📋 Description

• Oversee system-wide initiatives for hospital and physician services contracting as well as contract management.

• Develop strategies for contracting and manage the terms and performance of contracts.

• Facilitate the implementation and servicing of contracts throughout the entire system.

• Provide support for system-wide managed care education and communication efforts.

• Review contract language and suggest modifications, reimbursement changes, terms, and provisions with payors.

• Coordinate and assist in the timely processing of payer contracts and amendments.

• Collaborate with team members and internal departments to implement contracts and amendments.

• Monitor and track contracts, amendments, and renewals within a database.

• Offer problem-solving assistance to affiliates and departments.

• Acquire and distribute updates on payer manual changes, bulletins, benefit plan modifications, and other relevant documents.

• Engage in proactive communication, ensure contract compliance, and conduct educational sessions.

• Cultivate and maintain relationships with payers and internal stakeholders.

• Assess the financial and operational implications of procedural changes enacted by payors.

• Create and maintain tools for contracting decision-making and tracking.

• Take part in special projects as assigned by the Director or Vice President of Contracting.

• Execute additional duties as assigned.

⛳️ Requirements

• Bachelor's degree in Business or a related discipline.

• A minimum of three (3) years of experience in managed care.

• Experience in a contracting or provider relations capacity is preferred.

• In lieu of the educational and experience criteria: a high school diploma along with five (5) years of managed care experience in healthcare administration, health insurance, provider contracting, or a related field may be acceptable.

• Familiarity with the health insurance industry, particularly in managed care contracting operations and negotiation strategies.

• Knowledge of office equipment (fax/copier).

• Strong computer skills (word processing, spreadsheets, database management).

• Proficient mathematical skills.

🏝️ Benefits

• Comprehensive health insurance plans.

• Competitive salary and performance-based incentives.

• Opportunities for professional development and career advancement.

• Supportive work environment with a focus on work-life balance.