Contract Analyst

North American Dental Group•Pittsburgh, PA

9d•Remote

About The Position

Contract Analyst is part of the NADG Resource Center that supports The Professional Dental Alliance (PDA), which operates 200+ dental practices in 15 states. Contract Analyst manages the overall DSO/Plan relationship and is the health plans primary point of contact at NADG. Contract Analyst is responsible for negotiation and management of contracts with dental insurance plans as well as the overall payer strategy on behalf of The Professional Dental Alliance. Contract Analyst serves as a resource to all areas of NADG and provides timely guidance on payer issues. Contract Analyst may act as an intermediary between other NADG departments and/or practices and the health plan in resolving non-routine issues once available options have been explored/exhausted by all parties directly involved.

Requirements

A Bachelor’s degree in a healthcare, business, finance, or a related field.
2-3 years-experience in provider relations, payer relations or financial analysis within a healthcare organization
May consider qualified candidates in lieu of a bachelor’s with 7-9 years of directly related experience or relevant health care experience
Advanced Microsoft Office skills (Excel is a must), experience with Business Intelligence reporting preferred
Understanding of key performance metrics and performance reporting
High attention to detail with ability to analyze and summarize data

Nice To Haves

Dental or Health insurance plan experience preferred but not necessary
Knowledge of procedural coding systems as it relates to payer contracting is preferred but not necessary

Responsibilities

Analyze proposed rates by modeling and comparing reimbursement to determine contract value and potential revenue impact.
Work closely with Accounting and BI teams to procure data from available sources and develop reports to be used by the Payer Relations department
Perform timely entry of pertinent data into a contract management system or Matrix
Maintain accurate Participation Matrix by state and clinic
Maintain accurate TIN listing by state, practice, specialty
Maintain Leased, Tiered and Stacked Network Matrix
Proactively research payer policy changes that impact PDA/NADG
Continuously monitor contract performance and value, identifying new targets for renegotiation or biennial contract adjustment (COLA)
Assist with the entry of new rates into the Fee Schedule tables and perform regular maintenance of those tables
Assist with yearly UCR fee increase projects as assigned
Operate in compliance with all local, state, and Federal laws as well as NADG policy and compliance standards