Managed Care Operations - Analyst Payor Partnerships

ArchWell Health • Nashville, TN

18h

About The Position

The Analyst, Payor Partnerships supports payor relationships across ArchWell Health and the related operational functions of 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. The analyst supports payor contracts and relationships, provider data and directories, payer communications and operational processes, and analytical work for cross-functional stakeholders. The position offers an opportunity to develop knowledge and skills in healthcare operations.

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 that inform actionable strategic and financial business decisions.
• Strong communication skills, including the ability to explain complex problems succinctly and effectively to 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 formulas, PivotTables, graphing, and other reporting and presentation features.

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 communicate meaningful, actionable insights to cross-functional stakeholders.
• Interpret contractual language and apply a clear understanding of business rules for value-based care contracting.
• Perform other duties and special projects as needed, focusing on knowledge and skills development.

What This Job Offers

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