• Network Contract Analyst

    Job Locations US-PA-Harrisburg
    ID
    2019-16900
    Category
    Akeso
    Facility
    Akeso Talent Engagement - Harrisburg, PA
    Type
    Perm Placement
  • Overview

    Akeso Talent is looking to add a Network Contract Analyst to our team in order to performs research, analytic and reporting work in support of the Provider Contracting and Value Based Programs ACA agreements, provider reimbursement strategies and new contracting initiatives.

    Responsibilities

    The Network Contract Analyst performs contract administration activities encompassing among other tasks the preparation of contract settlements to ensure that claims are ultimately paid in accordance with the provisions of the contracts and that the Plan payment levels are reasonable and accurate based on the nature and scope of services rendered.

     

    The Network Contract Analyst works with team manager and other analysts from within the same unit, other Provider Operations areas or the negotiating team to develop and administer contracts between our client and various providers of health care services, including hospitals, non-hospital providers, ancillary providers and professional providers.Ake

    Qualifications

    1. Prefer a Bachelor's Degree in one of the following; accounting, business administration, health planning and administration OR an Associate’s degree AND sufficient level of work experience in health care or health care insurance pertaining to reimbursement or finance. 
    2. 2-3 years experience in a health care environment with proven analytical expertise is desired. 
    3. Strong oral and written communication skills.
    4. Ability to perform in a team environment.
    5. Ability to work independently with minimal supervision including the organization and prioritization of tasks to meet prescribed deadlines and department goals.
    6. Ability to recognize potential problem areas (i.e. those that materially affect reimbursement) and quickly differentiate between those which can be resolved directly versus those requiring assistance.
    7. Ability to perform analytical functions necessary to effectively and efficiently administer provider contract.
    8. Ability to perform data analysis and studies pertaining to aspects of provider reimbursement.
    9. Ability to review data and summarize it in a clear and concise manner incorporating industry knowledge to recommend solutions.
    10. Demonstrated ability to prepare detailed reports that accurately communicate the issue and recommended action in a clear and concise manner.
    11. Demonstrated ability to understand the nature and complexities of data and the relationships of data tables and elements within databases.
    12.   Ability to communicate with provider financial personnel on topics spanning from range of services to those relating to reimbursement.  This requires a high degree of professionalism in order to maintain good provider relations.
    13. Flexibility in work habits and patterns in order to respond to the constant and numerous changes impacting the health care environment.
    14. Demonstrated ability to drive results to completion while managing multiple projects and priorities.
    15. Demonstrated knowledge of and development experience with various tools such as Microsoft Office Suite products (Access, Excel, Word, etc.), Crystal Reports, Tableau, and SAS.  Ability to perform at an intermediate skill level in Access including query development, table joins, and formulas.  Ability to perform at an intermediate level in Excel utilizing formulas, pivot tables and other functions/formulas.  A working knowledge of claim and/or Facets data elements.
    16. Familiarity with Medicare and Medicaid reimbursement methodologies (facility and professional providers).
    17. Knowledge of general accounting practices and auditing procedures/techniques. 

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