Network Management & Contract Analyst

Excellus BCBS • De Witt, AR

1d • $62,400 - $106,929

About The Position

As a professional within the network contracting and administration team, the Network Management & Contract Analyst contributes to the development and maintenance of provider networks. The position performs provider and network analysis, evaluates provider reimbursement, and negotiates provider contracts in accordance with corporate strategy. The role requires an understanding of provider types, applicable legal and regulatory requirements, pricing methodologies, industry and regional provider impacts and trends, provider reimbursement and related programs, and product lines.

The position is accountable for maintaining network adequacy for assigned provider types, regions, and/or lines of business; preparing and presenting analysis and recommendations; coordinating contracting and administration work with stakeholders; and resolving inquiries and issues. It works directly with providers and internal clinical and operational leadership. The role also supports compliance with applicable legislative and regulatory mandates, corporate privacy policies, the Corporate Code of Conduct, and Lifetime Healthcare Companies’ mission, values, and Lifetime Way beliefs. Regular and reliable attendance is expected. Other functions may be assigned by management.

The listed compensation range is Grade E3, with a minimum of $62,400 and a maximum of $106,929. Actual salary may vary based on factors including budget, experience, knowledge, skills, education, and internal equity. The total rewards package may also include group health and/or dental insurance, a retirement plan, a wellness program, paid time away from work, and paid holidays. Remote work may be available on a case-by-case basis. The position may require travel across the Health Plan service region for meetings and/or training.

Requirements

• Six years of provider network reimbursement or related experience, or a bachelor’s degree in Health Care Administration or a relevant field.
• Two years of experience directly performing provider contracting or reimbursement analysis.
• Demonstrated experience with provider reimbursement methodologies.
• Ability to draft, interpret, and apply contractual language.
• Technical skills in modeling and financial analysis.
• Understanding of medical care delivery, industry trends, and regional market dynamics.
• Strong, persuasive, and effective verbal and written communication skills.
• Knowledge of health care products and services offered to members.
• Excellent problem-solving skills.
• Ability to work while sitting and/or standing at a workstation, viewing a computer and using a keyboard, mouse, and/or phone for three or more hours at a time.
• Ability to travel across the Health Plan service region for meetings and/or training as needed.

Responsibilities

• Establish and maintain network adequacy for assigned provider types, regions, and/or lines of business, and serve as the provider network contracting and administration subject matter expert for assigned areas.
• Analyze, develop, and propose formal provider reimbursement recommendations within approved budgets and according to health plan strategies.
• Identify, investigate, and analyze issues; collect and interpret information; and apply contract terms and regulatory and legal requirements to produce accurate, actionable analysis.
• Prepare and present information, findings, and recommendations to internal and external stakeholders.
• Liaise with assigned stakeholders to identify and coordinate provider network contracting and administration work items; execute initiatives and track, forecast, and report progress using qualitative and quantitative measures.
• Engage in provider contract negotiations and work routinely and directly with providers, clinical leadership, and operational leadership.
• Assist in preparing provider contracts, amendments, and communications.
• Maintain knowledge of relevant legislative and regulatory mandates to ensure compliance.
• Respond to and resolve provider and colleague inquiries related to provider network contracting and administration, and lead issue resolution with internal and external stakeholders.
• Support the Lifetime Healthcare Companies’ mission and values, adhere to the Corporate Code of Conduct, and lead according to Lifetime Way values and beliefs.
• Maintain high regard for member privacy in accordance with corporate privacy policies and procedures.
• Maintain regular and reliable attendance and perform other functions as assigned by management.

Benefits

• Group health and/or dental insurance may be included in the total rewards package.
• Retirement plan may be included in the total rewards package.
• Wellness program may be included in the total rewards package.
• Paid time away from work may be included in the total rewards package.
• Paid holidays may be included in the total rewards package.

What This Job Offers

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