Managed Care Operations - Analyst Payor Partnerships

ArchWell Health • Nashville, TN

13d

About The Position

The Analyst, Payor Partnerships supports payor relationships across ArchWell Health and the operational functions related to payors, including quality, revenue cycle, and contracting. The role focuses on building internal and external relationships, solving complex problems, conducting root cause analysis, and driving issues toward resolution. It is suited to a candidate interested in growth within healthcare operations.

The Analyst supports payor contracts and relationships, provider data management, and directory maintenance; coordinates payer communications and operational updates; and manages access, enrollment, and disenrollment across payer portals. The role also structures analytical results into clear, visual, actionable information for cross-functional stakeholders and interprets contractual language and business rules for value-based care contracting.

Requirements

• In-depth knowledge of provider network operations from a payor perspective and experience driving successful relationships between carriers and providers.
• Working knowledge of credentialing, provider data management, provider directories, Medicare Advantage, and membership attribution.
• Project management and communication skills.
• Demonstrated ability to conduct independent research and present solutions to complex problems.
• Ability to work collaboratively and independently to complete complex analyses leading to actionable strategic and financial business decisions.
• Strong communication skills, including the ability to explain complex problems succinctly and effectively for all levels of leadership.
• Ability to establish trusting, professional relationships with internal senior stakeholders.
• Bachelor's degree and 2–5 years of experience, or a high school diploma and 8 years of experience.
• Expertise in MS Excel, including proficiency with formulas, PivotTables, graphing, and other reporting and presentation features.
• Embodies and serves as a role model of ArchWell Health’s values: Be compassionate; Strive for excellence; Earn trust; Show respect; Stay resilient; Always do the right thing.

Nice To Haves

• Experience in consulting, managed care, and/or healthcare provider or payer settings.

Responsibilities

• Support payor contracts, payor relationships, provider data management, and directory maintenance.
• Coordinate payer communications and operational updates, including file distribution, provider network communications, network news, calendars, and contact lists.
• Manage payer portal access, enrollment, and disenrollment across multiple payer platforms.
• Facilitate operational processes, including payer updates, market communications, and distribution of required materials.
• Structure analytical results in an organized, visual manner to tell a meaningful, actionable story to cross-functional stakeholders.
• Interpret contractual language with a clear understanding of business rules for value-based care contracting.
• Execute other duties and special projects as needed, focusing on knowledge and skills development.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level