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Contract Management Analyst

Contract Management Analyst

Blue Cross Complete of Michigan LLCDetroit, MI, US
30+ days ago
Job type
  • Full-time
Job description

Role Overview

This position is responsible for working directly with the Director and Manager of Provider Network Management in dealings with provider agreements. The Contract Management Analyst will assist the Manager, Provider Network Management in administering the day-to-day business activities of developing, negotiating, and monitoring provider contract terms for fee-for-service and value-based reimbursement methodologies, including tracking and trending issues, developing revised processes or procedures, and coordinating with additional resources as needed to maximize the efficiency and effectiveness of services required under the provider agreements

Work Arrangement

  • Remote candidates must live in the state of Michigan

Responsibilities

  • Develops, implements, monitors, and assists in evaluating tracking mechanisms utilized by the Manager in maintaining overall provider agreement compliance
  • Participates in strategic relations activities as identified by the Manager and / or directed by the Director
  • Assists in developing collaborative ventures with departments within the Company, as needed, to maximize the efficiency and effectiveness of services under the provider agreements
  • Assists with completing required Alternative Payment Methodologies reporting
  • Develops, implements, monitors, and assists in service area expansion activities
  • Maintains and monitors the contract repository system
  • Assists with provider agreement approval process with various internal departments and the Department of Insurance and Financial Services

    • Education and Experience

  • A bachelor's degree in health care administration, Business, Public Health, or a related area or similar work experience
  • Michigan Medicaid policies - state and federal managed health care requirements
  • 3 to 5 years in a managed care-related or healthcare industry
  • Proven experience with contract management tools (i.e., we use Contract Manager, Emptpros)
  • Proficiency in researching regulatory requirements and managed care industry best practices

    • Skills & Abilities

  • Database development techniques and uses for various software options
  • Proficiency in PC usage, Windows, and Microsoft Office applications (Excel is essential)
  • Developing database tracking tools, data analysis, and reports

    • Your career starts now. We're looking for the next generation of healthcare leaders.

    At AmeriHealth Caritas, we're passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we'd like to hear from you.

    Headquartered in Newtown Square, PA AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

    Discover more about us at www.amerihealthcaritas.com.

    Our Comprehensive Benefits Package

    Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.

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    Contract Analyst • Detroit, MI, US