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Prisma Health · 3 weeks ago

Managed Care Contract Analyst, Corporate, FT, Day

Greenville, SC

Contract

Onsite

Senior Level

5+ years exp

Prisma Health is dedicated to transforming healthcare for the communities they serve. They are seeking a Managed Care Contract Analyst to coordinate system-wide hospital and physician services contracting, ensuring the effective implementation and performance of contracts while providing education and communication across the system.

Health CareHospitalMedical

Responsibilities

Coordinate the processing of all payer contracts and amendments. Coordinate all the steps required in the development, review and processing of new contracts, contract renewals and contract amendments with payers. Coordinate all required steps for the execution of contracts and amendments and ensure completion or execution of finalized contracts and amendments within specified time frames or deadlines. Perform detailed review of the business terms in contracts and amendments received from payers, identify unacceptable terms and recommend revised terms that meet the needs of Prisma Health. Negotiate single case agreements when necessary

Perform detailed analyses of the financial and operational impact of procedural changes implemented by payers

Develops and maintain contracting decision making and tracking tools

Develops model contracts or contract language for use in proposing contract or amendments to payers. Establish reporting techniques that will identify areas of concern and prepare recommendations to address any issues

Provide problem solving support to Prisma Health affiliates and departments. Work closely with payers to ensure that Prisma Health receives all provider manual changes, provider bulletins, benefit plan changes and other payer documents. This position distributes this information throughout Prisma Health in a timely fashion. Conduct pro-active communication, contract compliance, and educational sessions. Develop and maintain effective relationships with payers and internal customers

Qualification

Managed-care experienceContract negotiationHealthcare administrationHealth insurance knowledgeRelationship managementProblem solvingCommunication skills