Provider Contract Analyst

Lumeris Inc.; Arkansas; Sur place; USD 85 000 - 114 000; Plein temps

Avantages offerts par ce poste

Medical plans

Vision plans

Dental plans

PTO and leave

401k with company match

Employee Assistance Program

Learning and Development

Employee Discount Program

Résumé du poste

Lumeris is seeking a Provider Contract Analyst to manage end-to-end contracting for providers (ancillary, professional, facility) in a dynamic team. The role emphasizes contract analysis, negotiation for not-too-complex agreements, and accurate administration within the provider network.

A core requirement is in-market presence in IL, KY, AR, or MO to support in-market operations and relationships with providers.

Qualifications

• 5+ years of relevant experience in a managed care, health plan, or provider organization.
• Practical knowledge of provider contract language, reimbursement methodologies, and managed care principles.
• Skilled at interpreting contract data and solving moderately complex problems with limited supervision.
• Strong organizational skills and the ability to prioritize and manage multiple deadlines.

Responsabilités

• Manage a dedicated portfolio of contracts with providers (ancillary, professional and facility), independently handling renewals and new standard agreements.
• Analyze and interpret contract terms, rate proposals, and reimbursement methodologies to ensure alignment with standards.
• Resolve moderately complex provider inquiries related to contract interpretation, reimbursement, and operational setup.
• Partner with the Provider Partnership Liaisons to ensure smooth onboarding for newly contracted providers.
• Own the integrity of contract data within the contract management system for downstream reporting.
• Identify and recommend opportunities to improve contracting processes, templates, and workflows.

Formation

Bachelor's degree or equivalent experience

Outils

Contract management system

Description du poste

Your Future is our Future At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. We're excited to consider every qualified candidate authorized to work in the United States, although we are unable to sponsor visas for this role at this time.

Position: Provider Contract Analyst

Position Summary

The Provider Contract Analyst is a key professional role on the contracting team, responsible for managing the end-to-end contracting process for providers (ancillary, professional and facility). This role moves beyond administrative support and requires the ability to analyze contract terms, handle negotiations for less complex agreements, and solve problems independently. The Provider Contract Analyst will apply their knowledge of managed care to ensure our provider network is robust, cost-effective, and accurately administered, directly contributing to the team's strategic goals through diligent negotiation, accurate contract administration, and proactive management of the provider contract lifecycle. Success in this role is built on deep, trust-based relationships with our provider partners. Therefore, a core requirement of this position is residence within one of our key markets (IL, KY, AR, or MO) to ensure a consistent and impactful in-market presence.

Primary Responsibilities

• Manage a dedicated portfolio of contracts with providers (ancillary, professional and facility), independently handling the negotiation process for renewals and new standard agreements.
• Analyze and interpret contract terms, rate proposals, and reimbursement methodologies to determine appropriate action and ensure alignment with organizational standards.
• Solve moderately complex provider inquiries related to contract interpretation, reimbursement, and operational setup, serving as a knowledgeable point of contact.
• Partner with the Provider Partnership Liaisons to ensure a smooth, professional handoff and onboarding for newly contracted providers.
• Own the integrity of contract data within the contract management system, ensuring accuracy for downstream reporting and analysis.
• Identify and recommend opportunities to improve contracting processes, templates, and workflows to increase efficiency and accuracy.

Qualifications

• 5+ years of relevant experience in a managed care, health plan, or provider organization.
• Practical, working knowledge of provider contract language, reimbursement methodologies, and managed care principles is required.
• Skilled at interpreting contract data and solving moderately complex problems with limited supervision.
• Strong organizational skills and the ability to prioritize and manage multiple competing deadlines.
• Bachelor's degree or equivalent experience required.

Working Conditions: While performing the duties of this job, the employee works in normal office working conditions.

Pay Transparency: Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

• Hiring range for this position is: $84,600.00-$113,775.00

Benefits

• Medical, Vision and Dental Plans
• Tax-Advantage Savings Accounts (FSA & HSA)
• Life Insurance and Disability Insurance
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
• Employee Assistance Program
• 401k with company match
• Employee Resource Groups
• Employee Discount Program
• Learning and Development Opportunities
• And much more...

Additional Employment Details

• Member Facing Position: No — Not Member or Patient Facing Position
• Drug Screen Requirement: No
• MVR Required: No
• Credit Check Required: No
• Location: Arkansas
• Time Type: Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.

Disclaimer: The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.

Join Our Growing Team! Lumeris is bringing common sense back to the business of healthcare by empowering value-based care. We create the partnerships and perspectives that are making healthcare safer, more affordable and more personalized for providers, patients and payers alike. We were founded on the belief that it should be easier to provide the right care, at the right time, at the right cost. Our model is bringing that belief to life, improving outcomes and empowering financial sustainability along the way.

Why Join Lumeris? At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.