Provider Contracting Operations Analyst

Unclassified - Philadelphia, PA

Full-time - Mid Level

Philadelphia, PA

About the position

The Provider Contracting Operations Analyst plays a crucial role in overseeing the operations of the Provider Contracting team at Jefferson Health Plans. This position is responsible for coordinating the end-to-end processes of provider contracting, ensuring that contracts are executed efficiently, and maintaining accurate provider data systems. The Analyst will also engage in negotiations for physician and ancillary contracts, contributing to the organization's strategic and financial objectives.

Responsibilities

• Coordinates and oversees end-to-end contract workflow within Provider Contracting and Provider Reimbursement teams.
• Establishes and revises departmental policies, procedures, and workflows.
• Works with contracting and reimbursement teams to ensure that key contractual milestones and dates are tracked and monitored and that deadlines are met.
• Creates reporting and analytics for provider contract inventory, including renewal dates, contract end dates, and rate adjustments.
• Updates contract management system and provider databases with information and data from executed provider contracts.
• Ensures that fully executed contracts are promptly and accurately archived within the document control software.
• Issues standard contracts to providers and selected recruitment targets.
• Leads or assists with assigned negotiations for provider contracts and ensures that negotiations meet the company's strategic and financial goals and objectives.
• Performs other duties as assigned.

Requirements

• Bachelor's degree or 6 plus years of equivalent work experience.
• 2-4 years' experience in health care, managed care, or insurance contracting or related experience.
• Excellent attention to detail.
• Knowledge of managed care contracting and ability to read and comprehend standard contract language and terms.
• Strong knowledge of business applications (MS Teams, Excel, Word, Power Point & Access).
• Strong oral and written communication skills, as well as problem-solving, multitasking, and time management skills.
• Analytical thinking skills.

Benefits

• 401(k) matching
• Flextime
• Profit sharing
• Wellness program