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Requisition Number: 15026
Category: Professional – non-clinical
Facility: Finance (020)
Department: Contract & Managed Care
Schedule: Full-Time (60-80 hr/every two weeks)
Shift: Day
Hours: 8:00 am - 5:00 pm
Job Details:

Be a part of our award-winning team. We at Heartland want to make our service area the best and safest place in America to receive health care and live a healthy and productive life. At Heartland we believe our caregivers and medical staff are the key to our success.

 

As a valued caregiver:

The Contract Analyst is responsible for the evaluation, negotiation, monitoring and administration of managed care and other contracts and for researching issues related to managed care and other contracts (HMO's, PPO's, and variations).  Contracts may include hospital inpatient and outpatient services, as well as physician services. The Contract Analyst is also responsible for portions of net revenue analysis to include the cost accounting and billing systems.

 

Responsibilities include:

 

·       Performs detailed data analysis.

 

·       Manages contract software in all aspects.

 

·       Participates\leads process improvement discussion as necessary. Provides education as needed to personnel in all departments. Assures all policies and processes have been followed, with proper stakeholder involvement, prior to finalizing contracts.

 

·       Assists with analysis of new services or processes as needed.

 

·       Coordinates contract review through attorneys as necessary.

 

·       Manages workload to assure customer needs are met.

 

·       Drafts contracts as necessary.  Reviews contracts, analyzes, negotiates and finalizes contracts.  Facilitates discussion with contract owners as necessary.

 

·       Researches issues, evaluates opportunities, facilitates dispute resolution as necessary.

 

·       Fosters relationships with external parties.

 

·       Manages renewals as necessary, monitors  performance and reports findings/recommendations to the Team Leader and others as appropriate.

 

Caregivers in this position may also perform the following technical competencies for managed care contracts:

 

·       Works with managed care companies regarding reimbursement. Evaluates for accuracy, communicates information to internal stakeholders, and monitors performance. Maintains, validates and models payment information for patient accounting system, cost accounting system, monthly reporting and budgeting. Analyzes net revenue, payer policy, and employer movement among payers Manages payer activity and intent proactively.

 

·       Works with managed care companies to educate and discuss contracting options with Heartland Health.

 

·       Fulfills credentialing requirements for various insurance companies.

 

Education:

·       Bachelor's degree in business or finance related field.

 

Experience:

·       Three years experience in health care business setting preferred and three years managed care contracting preferred.

 

 

We offer a progressive work environment and a great atmosphere for career growth along with an excellent salary and an outstanding benefit package.

 

 

 



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