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VNS Health · 5 hours ago

Senior Contract Implementation Analyst

New York, NY

Full-time, Contract

Onsite

Mid, Senior Level

$77K/yr - $96K/yr

3+ years exp

VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations, committed to health and well-being for over 130 years. The Senior Contract Implementation Analyst will be responsible for configuring contracts and reimbursement terms, ensuring compliance, and collaborating with various departments to support contract implementation.

CharityHealth CareHome Health CareNon Profit

Responsibilities

Keeps abreast of current industry trends, governing regulations, reimbursement practices and market players. Keeps VNS Health Plans management informed of trends/changes and makes recommendations based on this information

Review and interpret managed care contracts, fee schedules, and related documents. Configure contract terms, payment rates, and rules within the organization's systems

Ensure that all contract configurations align with legal, regulatory, and organizational guidelines

Continuously update and maintain contract configurations as contracts are revised or amended

Collaborates with legal and compliance teams to stay updated on contract changes and regulatory requirements

Collaborates with internal departments and external vendors to ensure that annual benefit updates and pricing configurations are mapped, tested, documented, and loaded into production prior to the effective date of the contract. Ensures that fees and coverage rules are implemented annually or more often if dictated by regulating body

Analyzes contract terms and data to identify potential issues or discrepancies

Monitors contract performance and compliance with reimbursement terms

Provides insights and recommendations for improving contract efficiency and effectiveness

Works closely with Contracting and Provider Relations teams to resolve contract-related inquiries or issues

Assists in resolving disputes or conflicts related to contract interpretation. Collaborate with IT and data management teams to ensure system accuracy and integrity

Monitors and validates post-implementation reports to identify and fix configuration issues

Participates in interdepartmental work groups in support of process improvement projects, as needed

Conducts regular audits to verify the accuracy of contract configurations

Identifies and rectify errors or discrepancies in contract data

Produces Global Claim projects and claims analysis

Monitors new and existing process designs to measure operational effectiveness

Provides data collection and analytical support to team and monitors projects. Summarizes, creates, and distributes reports as needed

Participates in special projects and performs other duties as assigned

Qualification

Managed care contractsHealthcare information systemsProject managementHealthcare regulationsData analysisHealthcare terminologyEffective communicationAttention to detailProblem-solving