Provider Contract Analytics Specialist

Capital Blue Cross; Harrisburg (Dauphin County); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical benefits

Dental & Vision

Retirement plan

Paid time off

Volunteer time off

Tuition reimbursement

Job summary

Capital BlueCross seeks a Network Contract Analyst to support contract administration, settlements, and provider reimbursement analyses. You will work with the Provider Contracting and Value Based Programs teams to ensure accurate payments aligned with contract terms and plan policies.

The role involves data analysis, preparing settlements, and contributing to new contracting initiatives. Experience with provider pricing and reimbursement methodologies is preferred.

Qualifications

• 2-3 years’ experience in health care analytics or reimbursement.
• Strong analytical and reporting abilities.
• Familiarity with provider contract provisions and reimbursement practices.

Responsibilities

• Develop annual plan for the team considering resources and workload.
• Perform analytic functions to administer provider contracts.
• Prepare settlements reflecting contract payment provisions.
• Develop settlements when current payments don’t meet provisions.
• Manage CRA process including data reconciliation and analysis.
• Draft and revise workflows for contract administration.

Skills

Interpersonal skills

Communication skills

Independent work

Task prioritization

Team collaboration

Education

Bachelor's Degree in accounting/finance

Associate degree with healthcare reimbursement experience

Tools

Microsoft Office

Crystal Reports

Tableau

SAS

Job description

Capital BlueCross seeks a Network Contract Analyst to support contract administration, settlements, and provider reimbursement analyses. You will work with the Provider Contracting and Value Based Programs teams to ensure accurate payments aligned with contract terms and plan policies.

The role involves data analysis, preparing settlements, and contributing to new contracting initiatives. Experience with provider pricing and reimbursement methodologies is preferred.