ProfessionalServices – Contracts Analyst 2 Contracts Analyst 2 Position Available In [Unknown county], Florida

ProfessionalServices – Contracts Analyst 2 Contracts Analyst 2#25-55791
Various, FL
All On-site Job Description

Job Description:

Summary:

Serve as the subject matter expert to on issues related to provider reimbursement

Job Responsibilities:

Evaluate the effectiveness of contracting strategies, payment methodologies and rates in comparison to budget of quality initiatives Establish financial benchmarks for provider reimbursement and analyze the impact of contracts submitted by the Health Plans Manage and modify the process for changes to outcomes analysis reports due to various needs and concerns Prepare and present information on emerging and industry standard reimbursement methods, competitive information, and national initiatives to management in support of network strategy discussions Oversee various projects including the design of physician incentives and other contractual arrangements Maintains divisional provider reimbursement models providing analytic reporting capabilities for contracting staff, contract settlement, incentive pool distribution, and estimation of savings through a variety of proposed contract/reimbursement actions Perform analyses of Health Plan reimbursements in comparison to •’s national experiences Develop, export and train Health Plan financial analysts on the use financial modeling tools for provider reimbursement and medical expense forecasting Assist with formulating and administering organization policies and procedures

Education/Experience:

Bachelor’s degree in related field or equivalent experience. Working knowledge of contract management processes, claims processing procedures, reimbursement and payment methodologies, and claims systems requirements and controls. Experience with statistics and the application of higher level mathematical models to medical and pharmacy claims data.2-4 years of experience
Comments for

Vendors:

Must work in the

United States EEO:

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.” ==========
Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):
Through communication and solid relationship management with internal and external stakeholders, this role will review, draft, and negotiate agreements with procurement vendors and administer all activities related to vendor contracts for the purchase of professional and enterprise services commodities (facilities, consulting, travel, memberships/claims, HR/marketing), information technology commodities (software, hardware, telecom, security), and health operations commodities (population health & clinical operations, pharmacy, quality & risk adjustment, payment integrity).

Agreement types include:

master service agreements (MSA), business associate agreements (BAA), delegated services agreements, statements of work (SOW), nondisclosure agreements (NDA), service level agreements (SLA), software license agreements, and related third-party contracts. Drafts and approves amendments, terminations, contract summaries, and other contract-related tasks. Reviews, interprets, and advises relevant departments of contractual rights and obligations. Ensures compliance with policies and procedures, as they relate to legal, contractual, and risk management standards.
Describe the performance expectations/metrics for this individual and their team:
Manage queue of assigned tasks, respond timely to all requests, compliance with policy/procedures, partner with internal stakeholders and functional groups to understand Centene contract standards and fallback positions, timely and professional contract negotiations with vendors
Tell me about what their first day looks like:
Access and overview of systems, policies, procedures and introduction to team and key stakeholders/partners
What previous job titles or background work will be in this role?
Contracts Negotiator, Contract Management, Sourcing Analyst, Senior Buyer, Paralegal, Legal/Contracts Analyst
What makes your team/department/culture special that you would like candidates to know?
We are a large team who work very closely to support each other with complex contract negotiations. There is opportunity to learn contracting across various categories of spend.
What red flag(s) would cause you to immediately disqualify a candidate?
Lack of experience or customer service mentality
Any future projected positions potentially coming up? Choose an item. If yes, note: