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Balance Health · 1 month ago

Senior Contracts & Network Operations Analyst

United States

Full-time

Remote

Senior Level, Lead/Staff

15+ years exp

Balance Health is seeking a Senior Contracts & Network Operations Analyst responsible for leading the design, implementation, and maintenance of healthcare contract management processes. The role involves interpreting complex contract terms, conducting reimbursement reviews, and ensuring operational efficiency while collaborating across departments.

Cosmetic SurgeryHealth CareTherapeuticsWellness

Responsibilities

Design, implement, and maintain a centralized contract management repository and execution workflow that ensures visibility, compliance, and accessibility

Develop standardized procedures for contract routing, review, approvals, and archiving

Support automation and integration of contract data into operational and reporting systems

Monitor contract status, expirations, and renewals to ensure timely execution

Review, redline, and summarize agreements to ensure consistency with organizational standards and payer requirements

Collaborate with operations and finance teams on rate and language strategy

Conduct 1st level review of Fair Market Value (FMV) reimbursements to ensure compliance and alignment with industry standards

Recommend improvements to recurring contract templates or standard language

Serve as a subject-matter resource for interpreting contract terms and payer relationships for internal partner teams

Provide guidance on contracting entities, reimbursement terms, credentialing requirements, and participation status

Work with IT and leadership to develop a ticketing system to log, assign, and resolve workflows for the department

Partner with credentialing and network enrollment teams to utilize contract terms to streamline provider onboarding and participation approvals

Clarify payer-specific credentialing and participation requirements derived from contract language

Support resolution of enrollment or credentialing escalations requiring interpretation of payer or network agreements and / or finding an appropriate escalation path

Identify opportunities to improve efficiency and compliance within the contract lifecycle

Participate in cross-functional initiatives to enhance data integrity and visibility across departments

Assist in the development of dashboards, metrics, and reports to track contract activity and inquiry resolution

Qualification

Healthcare contract analysisContract management softwareHealthcare reimbursement modelsAnalytical skillsNegotiation skillsCommunication skillsContract reviewRedliningMicrosoft Office proficiencyCRM/ticketing tools proficiencyRelationship managementOrganizational skillsAttention to detailConfidentiality management

Required

Bachelor's degree in Healthcare Administration, Business, Legal Studies, or a related field required

Equivalent combination of education and experience may be considered

15+ years of experience in healthcare contract analysis or management

Deep understanding of healthcare reimbursement models, managed care, and regulatory frameworks

Familiarity with payer-provider dynamics and network contracting

Monitor contract performance and enforce service-level agreements (SLAs)

Proficiency in contract management software

Exceptional negotiation, analytical, and communication skills

Strong organizational skills with attention to detail

Proficiency in contract review, redlining, and summarizing complex language for non-legal audiences

Excellent written and verbal communication abilities

Proficient in Microsoft Office (Word, Excel, PowerPoint) and CRM/ticketing tools (e.g., Jira, Zendesk, ServiceNow)

Ability to manage multiple priorities and maintain confidentiality

Strong understanding of factors influencing contract relationships, including the impact of provider information changes and integration of new provider additions

Ability to form and maintain external and internal relationships