Contract Analyst

Apply for this Position

Application Form     (* indicates required field)

Please attach the following files

Please upload either a word or PDF version of your cover letter for this position.
Please upload either a word or PDF version of your current resume.
Such as letters of recommendation, work examples, etc.

In consideration of my employment , I agree to conform to the policies and procedures of Saint Francis Healthcare Partners (hereafter “SFHCP”), as they may from time to time be implemented or revised, and that my employment and compensation are “AT-WILL” and can be terminated with or without cause at any time for any lawful reason at the option of either SFHCP or myself. I understand that should I be granted an interview, no representations that may be made at the interview are to be construed as creating any obligation, promise or contract on behalf of SFHCP that in any way would limit SFHCP’s right to terminate my employment at will. I understand that no supervisory, management or any other employees at SFHCP, except for the CEO, has any authority to make a commitment of guaranteed or continuing employment to me, and no document or publication of SFHCP or conduct of anyone at SFHCP should be interpreted to make such a guarantee, unless the CEO specifically acknowledges such change in writing.

I certify that the answers given in this application are true to the best of my knowledge; I understand that misrepresentations, falsifications, or material omissions given in my application, resume, interview or during the course of my employment may result in withdrawal of a job offer of employment or corrective action up to, and including termination of employment, whenever the omission or falsification is discovered. I understand that acceptance for employment shall depend on satisfactory replies from my references and other background checks.

I have applied for employment at SFHCP. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I authorize representatives of SFHCP to obtain pertinent information from my previous employers, references, and other persons with knowledge of my work history and background. I authorize all previous employers, references or other persons having knowledge of my record or myself to release such information to SFHCP, and hereby release all persons from liability for any damage that may result from furnishing such information to SFHCP. A photocopy of this authorization may be accepted in lieu of the original.

You must agree to the disclosure statement provided in order for us to accept your application.

To finalize your application, please confirm you are not a bot

You will receive confirmation after we have received your application.

SUMMARY OF RESPONSIBILITY:

The Contract Analyst position is responsible for performing analytics related to contract modeling, negotiation and ongoing management using a variety of tools. The position provides support to the VP Payer Partnerships, Regional Directors, Payer Partnerships, Regional Manager, Contract Analytics and the Contract Administrators with the review, evaluation and preparation of managed care contract rate proposals.  The position participates in the design and production of payer report cards to monitor contract performance and support contract compliance.  The position serves as a resource for contract and financial analysis for other departments in the organization and works directly with those departments and payers to manage problem resolution and ensure accurate and timely information is available. The position must maintain positive relationships with payers and providers and may assist with the communication of agreements to providers and key staff across Trinity Health New England, including educating the providers and staff on key terms within the agreements.  Primary scope of work includes hospital, physician and ancillary provider contracts and commercial, managed Medicare and managed Medicaid lines of business.

 

Essential Functions:  

  • Conducts detailed managed care contract modeling and analysis utilizing current contract modeling systems in place, in support of contract negotiations and ongoing management.  Contracts include fee for service and value-based models that cover physician, hospital and ancillary providers/services. 

  • Investigates individual and systematic payment issues identified by department analyses or communicated by providers (e.g. physician practice managers, Revenue Integrity, Finance, etc.).  Makes recommendations that address such issues in current and future contracts.

  • Develops payer matrices including key comparative metrics, contract terms, and renewal dates for use by management team.

  • Establishes and maintains positive relationships with managed care payers in order to facilitate sharing of information, analyses and other information important to the provider/payer relationship.

  • Stays current with the changes in reimbursement models as it relates to value based contracting models.

  • Prepares ad hoc reports, analyses and supportive data at the request of the Regional Manager, Contract Analytics.

  • Participates in payer Joint Operating Committee meetings (JOC) and payer relationship meetings as necessary.

  • Communicates to staff of contracting initiatives as well as payer bulletins and changes to billing requirements reimbursement procedures, and medical policies that may impact prior authorization and other established processes.

 

Other Functions:

  • Assists in the maintenance of physician fee schedules and/or hospital rate schedules.

  • Assists in the preparation of documents required by the Trinity Health Executive Contracting Oversight Committee.

  • Assists in assessing rate compliance and monitors all changes made to contract terms.

  • Assists with preparation of Trinity Health ECOC presentations.

  • Assists in the maintenance and scanning/storage of all executed agreements.

  • Performs other duties as assigned.

 

The duties listed above are intended only as illustrative of the various types of work that may be performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar or a logical assignment to the position.

QUALIFICATIONS AND COMPETENCIES:

  • Bachelor’s degree in health management, finance or related field is required.

  • Three or more years of experience of healthcare contracting or analysis is required. 

  • Solid working knowledge of contractual, health insurance and operational issues related to managed care organizations, physician groups, hospitals and health insurance benefit plan designs is required. 

  • Solid working knowledge of healthcare data such as claims, provider, eligibility data as well as clinical quality algorithms for Commercial, Medicaid and Medicare products is required.

  • Strong understanding of managed care metrics (PMPM, capitation, utilization and average cost) is required. 

  • Strong working knowledge of MS Office suite applications is required.

  • Demonstrated experience using analytical reporting tools, e.g. Microsoft Excel, Access and Crystal Reports is required.

  • Experience with Contract Modeling systems preferred

  • Excellent critical thinking/problem solving skills. 

  • Effectively anticipates needs and problems. Recognizes capabilities and utilizes others/resources to optimize patient care. 

  • Self-directed, organizes and prioritizes work and manages multiple tasks and assignments.  Manages time well and performs assigned duties with attention detail, accuracy and follow-through with minimal supervision. 

  • Deals with confidential information in a professional manner. 

  • Skilled at working closely in fast-paced, multi-disciplinary, team environment.

  

Location: Hartford, CT
Apply for this Position
Apply at: https://sfhcp.prismhr-hire.com/job/72218/contract-analyst