Provider Contract Analyst

Lumeris•Arkansas, AR

7d•$84,600 - $113,775•Hybrid

About The Position

At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. We're excited to consider every qualified candidate authorized to work in the United States, although we are unable to sponsor visas for this role at this time. The Provider Contract Analyst is a key professional role on the contracting team, responsible for managing the end-to-end contracting process for providers (ancillary, professional and facility). This role moves beyond administrative support and requires the ability to analyze contract terms, handle negotiations for less complex agreements, and solve problems independently. The Provider Contract Analyst will apply their knowledge of managed care to ensure our provider network is robust, cost-effective, and accurately administered, directly contributing to the team's strategic goals through diligent negotiation, accurate contract administration, and proactive management of the provider contract lifecycle. A core function of this job is local relationship management and establishing a strong community presence. To achieve this, candidates must reside in their assigned market (e.g., IL, KY, AR, MO). While this role offers the flexibility of a home-based office, it requires regular, in-person engagement with providers and community leaders within the market. The scheduling of these local visits is largely autonomous, planned in partnership with your leader to meet strategic goals. In addition to this local focus, this role is part of a regional team and may be required to manage work for providers outside of the assigned geographical market. Occasional out-of-market travel for mandatory team meetings will also be required.

Requirements

Must reside within one of our key markets (e.g., IL, KY, AR, or MO) to facilitate required in-market provider engagement.
This role requires regular in-market community presence, with an expectation of at least one day a week dedicated to local, in-person meetings with providers and community partners. The scheduling of this local activity is autonomous and managed by you in partnership with your leader.
Occasional out-of-market travel (e.g., 2-4 times per year) is also required for mandatory team meetings and may involve overnight stays.
All approved overnight hotel stays and personal vehicle mileage for business purposes are reimbursable according to company policy.
5+ years of relevant experience in a managed care, health plan, or provider organization.
Practical, working knowledge of provider contract language, reimbursement methodologies, and managed care principles is required.
Skilled at interpreting contract data and solving moderately complex problems with limited supervision.
Strong organizational skills and the ability to prioritize and manage multiple competing deadlines.
Bachelor's degree or equivalent experience required.

Responsibilities

Establish a strong community presence by actively building and maintaining collaborative relationships with providers and community leaders through autonomous, regular in-person engagement within your assigned market.
Manage a dedicated portfolio of contracts with providers (ancillary, professional and facility), independently handling the negotiation process for renewals and new standard agreements.
Contribute to the overall contracting strategy by managing contract assignments for providers located outside of your primary market as business needs require, ensuring equitable workload distribution and team success.
Analyze and interpret contract terms, rate proposals, and reimbursement methodologies to determine appropriate action and ensure alignment with organizational standards.
Solve moderately complex provider inquiries related to contract interpretation, reimbursement, and operational setup, serving as a knowledgeable point of contact.
Partner with the Provider Partnership Liaisons to ensure a smooth, professional handoff and onboarding for newly contracted providers.
Own the integrity of contract data within the contract management system, ensuring accuracy for downstream reporting and analysis.
Identify and recommend opportunities to improve contracting processes, templates, and workflows to increase efficiency and accuracy.