Principal Provider Contract Analyst

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

📋 Description

• Oversee executive-level relationships with designated health systems and provider organizations.

• Act as the primary point of accountability for intricate and escalated provider issues.

• Formulate, negotiate, implement, and manage complex provider contracts and reimbursement frameworks.

• Spearhead initiatives related to value-based care, shared-risk, strategic networks, cost management, quality, performance, product strategy, incentives, and contract administration.

• Direct cross-functional teams and engage stakeholders in discussions to address provider issues and promote strategic plan initiatives.

• Act as a subject-matter expert for assigned providers regarding contract and relationship status, trends, innovations, and opportunities.

• Organize provider engagement activities and educational requirements in collaboration with the strategic relationship support analyst.

• Co-lead provider meetings and executive touchpoints, including agenda creation, facilitation, documentation, and follow-up.

• Create business cases, financial analyses, feasibility studies, and forecasting models.

• Track provider performance and enhance quality, affordability, member experience, and value-based care outcomes.

⛳️ Requirements

• Bachelor's degree or advanced degree (if applicable), or 10+ years of experience in place of a degree.

• At least 8 years of experience in a related field.

• Demonstrated experience in healthcare provider contracting, network management, provider relations, or managed care, with accountability for large health systems and strategically important provider organizations.

• Proven track record in leading complex provider contract negotiations, including value-based care arrangements, risk-sharing models, alternative payment methodologies, and reimbursement innovations.

• Exceptional ability to cultivate and maintain executive-level relationships with health system executives, physician leaders, and senior healthcare stakeholders.

• Experience in leading cross-functional strategic initiatives that involve network strategy, finance, actuarial science, clinical operations, legal matters, and product teams.

• Strong financial and analytical skills, encompassing provider economics, contract modeling, forecasting, performance analysis, and cost management.

• Familiarity with healthcare reimbursement methodologies, value-based care principles, regulatory requirements, and healthcare market dynamics.

• Candidates must reside in North Carolina.

• Some travel within North Carolina is necessary.

🏝️ Benefits

• Medical, dental, and vision insurance.

• Health and wellness initiatives.

• Parental leave and support services.

• Assistance for adoption and surrogacy.

• Career development opportunities.

• Tuition reimbursement for ongoing education.

• 401k matching with an annual company contribution.

• Paid Time Off (PTO).

• Annual Incentive Bonus based on the achievement of corporate goals and individual performance.

• Remote-Flex work arrangement with a limited number of in-office visits each year.

• Emphasis on work-life balance, flexibility, and autonomy.