Provider Contracting and Operations Analyst

Why Choose Jefferson Health Plans?We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children's Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.While this job currently provides a flexible remote option, due to in-office meetings, training as required, or other business needs, our employees are to be residents of PA or the nearby states of DE or NJ.Perks of JHP and why you will love it here:Competitive Compensation Packages, including 401(k) Savings Plan with Company Match and Profit Sharing Flextime and Work-at-Home OptionsBenefits & Wellness Program including generous Time Off Impact on the communities we service We are seeking a talented and enthusiastic Provider Contracting Operations Analyst to join our team!The Provider Contracting Operations Analyst assists with overseeing the Provider Contracting team operations, data and workflows. The Analyst is responsible for coordinating the provider contracting end-to-end processes, which include the contract execution process, updates to the provider data systems, and tracking tools for all JHP contracts. The Provider Contracting Operations Analyst may also be responsible for leading ancillary and physician contracting negotiations.As the Provider Contracting Operations Analyst, your daily duties may include: 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 (e.g., renewal dates, contract end dates, 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 (e.g., physician, and ancillary) and ensures that negotiations meet the company's strategic and financial goals and objectives. Perform other duties as assigned.Qualifications 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. Skills, We Value: 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.

Created: 2024-11-01