Managed Care Contract Analyst, Corporate Greenville, FT, Day - Remote

Prisma Health; Greenville (SC); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a detail-oriented individual to coordinate hospital and physician services contracting. This role involves managing contract performance, analyzing operational impacts, and developing decision-making tools. The ideal candidate will have experience in managed care and a strong understanding of negotiation techniques. The position offers the flexibility of remote work, allowing you to contribute to transforming healthcare while enjoying work-life balance. Join a team dedicated to making a difference in the communities served.

Qualifications

• 5 years of managed-care experience or healthcare administration.
• Strong knowledge of managed-care contracting operations.

Responsibilities

• Coordinate processing of all payer contracts and amendments.
• Analyze financial impacts of procedural changes by payers.
• Provide problem-solving support to internal departments.

Skills

Managed-care experience

Contract negotiation

Healthcare administration

Health insurance knowledge

Problem-solving

Education

Bachelor's Degree

Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Coordinate system-wide hospital and physician services contracting, including strategy formulation, contract terms, and contract performance. Manage the implementation, presentation, and servicing of all contracts across the system. Provide system-wide managed care education and communication.

Remote work can be considered for this position.

Accountabilities

• Coordinate the processing of all payer contracts and amendments, including development, review, and processing of new contracts, renewals, and amendments. Ensure timely execution and review of business terms, negotiate single case agreements if necessary. 40%
• Analyze the financial and operational impacts of procedural changes implemented by payers. 10%
• Develop and maintain contracting decision-making and tracking tools. 10%
• Create model contracts or language for proposals, establish reporting techniques, and recommend solutions for identified issues. 15%
• Provide problem-solving support to Prisma Health affiliates and departments, ensure timely receipt and dissemination of payer documents, and conduct educational sessions. Build and maintain effective payer and internal relationships. 25%

Supervisory/Management Responsibilities

• This is a non-management role reporting to a supervisor, manager, director, or executive.

Minimum Requirements

• Bachelor's Degree.
• 5 years of managed-care experience, preferably in contracting or provider relations. Alternatively, 5 years in healthcare administration, health insurance, or provider contracting.

Required Certifications/Registrations/Licenses

• N/A

Other Required Skills and Experience

• Knowledge of the health insurance industry, especially managed-care contracting operations and negotiation techniques.

Work Shift

Day (United States of America)

Location

Prisma Health Corporate Office

Facility

7001 Corporate

Department

70019069 Managed Care Contracting

Share your talent with us! Our vision is to transform healthcare for the communities we serve. We seek talented individuals in every role at Prisma Health.