CONTRACT ANALYST – BUSINESS SERVICES

Lewes, Delaware,     Summary: The Contract Management Analyst is responsible for preparing financial and risk analysis for payer contract management and contract negotiations. Designs models and performs ad hoc analysis for the purpose of understanding the historical and future performance of existing contracts; synthesizes and reports data to management. Assists in negotiating contracts and maintaining contract management software. Responsible for maintaining relationships with payers and communicating directly with payer representatives to report and resolve payment discrepancies or denial issues related to contract terms. Provides advice on how to proceed in complex cases when contract guidelines and language need clarification.   Other information: Healthcare analytical experience, including at least three years progressively responsible work experience in healthcare finance, required. Experience working with cross-functional departments to research and resolve issues using innovative solutions preferred Minimum of three years of data or financial analytical experience required. Healthcare analytical experience, including at least three years progressively responsible work experience in healthcare finance, required. Experience working with cross-functional departments to research and resolve issues using innovative solutions preferred. Five years of data or financial analytical experience in a Healthcare SettingStrong computer application skills and working knowledge of database management and systems.

Excellent analytical, organizational, and computer skills. Proven strong communications skills. Ability to interact with hospital leadership and peers in a professional and courteous manner. Knowledge of managed care reimbursement methods, medical terminology, medical and healthcare billing and collections.   Responsibilities: Perform a wide range of high-level and detailed analytical functions for contract management and negotiation, including but not limited to financial performance, reimbursement comparisons, risk analyses, and quality program assessments. Create and communicate complex financial and risk models for the purposes of evaluating historical and future performance of existing contracts. Develop and produce financial reports on a periodic and ad hoc basis for hospital management. Assist in negotiating contracts, maintaining contract management software, analyzing financial impact, and monitoring payments for compliance. Support the managed care division’s initiatives through analysis and performs forecasts on the impact of reimbursement terms during contract negotiation process. Assist in the preparation, processing, research, and analysis of Medicare, Medicaid, and managed care cost reports to ensure the accuracy of claim payments.

Assist in the preparation of third-party contractual allowances for inclusion in financial statements. Review managed care contracts to determine appropriate application of rates, provisions, and terms. Interact with various hospital stakeholders, department heads, and physicians to educate staff related to managed care reimbursement models. Work with departments to develop and maintain specific payment arrangements for unique services. Collaborate with legal department to develop contract language. Identify potential underpayment trends through comparison of managed care contracts to actual reimbursement information via contract management technology. Investigate third-party payer policies and contracts to verify accuracy of underpayment variances according to published payer guidelines. Provide documentation for third-party payer audits. Provide reimbursement information and analysis to other hospital departments. Maintain knowledge of reimbursement regulation.

    Competencies and skills: Essential:
* Clear Communication Skills Both Written And Verbal
* Knowledge Of Basic Computer Programs
* Able To Keep Confidential Information Regarding Patients, Team Members
* Able To Withstand Crisis Situations
* Has Skills To Provides Customer Service To Patients, Team Members And Visitors
* Experience Or Completed Courses In Coding   Education: Essential:
* Bachelor’s Degree in related field    Education specialization: Essential:
* Accounting   Education equivalent experience: Essential:
* OR FINANCE OR BUSINESS   L ocation: Hospital-Main Campus   Shift : 8am-4:30pm Monday – Friday   FTE: 1. 000000     Work Status: Full Time                

Source ⇲