Excellus BCBS · 1 month ago
Network Management & Contract Analyst
DeWitt, NY
Full-time, Contract
Onsite
Mid, Senior Level
$60K/yr - $107K/yr
6+ years expExcellus BCBS is a healthcare company focused on provider networks and contracting. The Network Management & Contract Analyst will contribute to the development and maintenance of provider networks, perform analysis and negotiate contracts in alignment with corporate strategies.
Health CareHealth InsuranceNon Profit
Responsibilities
Establishes and maintains network adequacy for assigned provider types, regions and/or lines of business. Serves as provider network contracting and administration subject matter expert for assigned areas
Analyzes, develops, and proposes formal provider reimbursement recommendations within approved budgets and according to health plan strategies
Identifies, investigates, and analyzes issues and questions. Collects and interprets data and information to support provider network contracting and administration activities. Applies applicable contract terms, regulatory and legal requirements, and other information to produce accurate and actionable analysis
Effectively prepares and presents information, findings, and recommendations to internal and external stakeholders
Serves as liaison with assigned stakeholders to identify and coordinate provider network contract and administration work items. Executes initiatives; tracks, forecasts and reports on progress including qualitative and quantitative measures
Engages in provider contract negotiations. Works routinely and directly with providers, clinical, and operational leadership
Assist in the preparation of provider contracts, amendments, and communications
Maintains knowledge of relevant legislative and regulatory mandates to ensure compliance
Responds to and resolves inquiries from providers and colleagues related to provider network contracting and administration. Leads issue resolution with internal and external stakeholders
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs
Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures
Regular and reliable attendance is expected and required
Performs other functions as assigned by management
Qualification
Required
Six (6) years of provider network reimbursement or related experience required. Or a Bachelor's degree in Health Care Administration or relevant field
Two (2) years of experience directly performing provider contracting or reimbursement analysis required
Demonstrated experience of provider reimbursement methodologies
Ability to draft, interpret and apply contractual language
Technical skills including modeling and financial analysis
Understanding of medical care delivery, industry trends, and regional market dynamics
Strong, persuasive, and effective verbal and written communication skills
Knowledge of health care products and services offered to members
Excellent problem-solving skills
Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time
Ability to travel across the Health Plan service region for meetings and/or trainings as needed
Benefits
Participation in group health and/or dental insurance
Retirement plan
Wellness program
Paid time away from work
Paid holidays
Company
Excellus BCBS
Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to about 1.5 million people across upstate New York.
5001-10000 employees
H1B Sponsorship
Excellus BCBS has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (18)
2023 (12)
2022 (15)
2021 (17)
2020 (20)
Funding
Current Stage
Late StageLeadership Team
Jeremy Donath
Director, Provider Reimbursement Analytics & Operations
Recent News
Rochester Business Journal
2026-01-03
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2025-12-07
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