Provider Contract Analyst

The Opportunity

America’s PPO is currently seeking a Provider Contract Analyst responsible for implementation and maintenance of provider contracts for our Preferred Provider Network. This role is integral in streamlining and developing processes and ensuring client expectations are exceeded while increasing revenue and decreasing expenses. This individual will establish and foster strong positive relationships with providers and internal staff. Additionally, this individual will ensure timely and accurate implementation of provider contracts, amendments, terminations, and provider demographics.

What you'll do

• Reach out to providers offices to contract with the network, also respond to inquiries from provider offices looking to contract with the network.
• Develop and maintain service relationships with participants of the network.
• Collaborate with network team to efficiently triage and manage provider email inquiries.
• Respond to electronic and direct inquiries from providers and internal customers about contracts, pricing, claims, fee schedules, network application requests and statuses, rate changes, billing and payment.
• Independently and as part of a team, recruit, build and negotiate contract terms with a wide variety of providers.
• Plan and prepare for negotiations assessing, valuing and prioritizing issues and alternative solutions, anticipating needs and/or interest of parties in the negotiation.
• Ensure that negotiated terms and conditions are accurately reflected in binding contractual language and effectively communicated within the organization.
• Implement new provider contracts using standard payment structures and reimbursement rates with timely response and follow up under guidance from contract management team.
• Ensure accurate data entry, system configuration, and audit of the below, providing timely response to status requests for internal and external stakeholders.
  • network applications
  • provider contracts/amendments
  • fee schedule updates
  • demographic changes (Tax ID, address, name, etc)
• Prepare reports, compiles and analyzes data and maintains pertinent historical information.
• Investigate and coordinate resolution of provider billing and claims concerns.
• Responsible for a high level of service excellence, data entry and email communication
• Support continuous improvement of the contract lifecycle and implementation.

What we expect from you

• Bachelor’s degree or an Associate Arts degree in a related field of healthcare, business management or 3 years of related work experience; healthcare experience preferred.
• Ability to effectively communicate in both written and verbal forms with strong attention to detail.
• Ability to manage multiple, time critical deadlines.
• Ability to work collaboratively across many teams within an organization.
• Excellent interpersonal and customer service skills.
• Proficient in multiple software applications including Microsoft Office.

We make healthcare EZ!

Additional Opportunity Details:

Target Base Compensation Range for this role is $50,000-$60,000*

• Factors that may be used to determine your actual salary include your job specific skills, education, training, job location, number of years of experience related to this role and comparison to other employees already in this role.

Employee benefits are part of the competitive total rewards package that HealthEZ provides to you. Our comprehensive benefits program includes health benefits, retirement plan (401k), paid time away, paid leaves (including paid parental leave) and more.

HealthEZ recognizes its responsibilities under federal, state, and local laws requiring non-discriminatory employment practices. All employment decisions, practices and procedures will be carried out without regard to race, color, creed, religion, sex (including pregnancy), sexual orientation, national origin or ancestry, age, marital status, disability, family status, status with regard to public assistance, or any other characteristic protected under applicable local, state, and federal laws.

HealthEZ is proud to be an equal opportunity employer.