Provider Network Contracts Analyst - Remote-Eligible

Univera HealthСare; City of Rochester (NY); Remote; USD 62,000 - 107,000; Full time

Job summary

Univera Healthcare in Rochester, NY is seeking a network contracting and administration professional who will help develop and maintain provider networks, evaluate reimbursement, and negotiate contracts in line with corporate strategy.

The role requires deep understanding of provider types, regulatory requirements, pricing methods, and market trends, with responsibilities spanning data analysis, stakeholder communication, and cross-functional teamwork.

Qualifications

• Six years of provider network reimbursement or related experience.
• Two years of provider contracting or reimbursement analysis.
• Experience with provider reimbursement methodologies.
• Ability to draft, interpret and apply contractual language.
• Technical skills including modeling and financial analysis.
• Understanding of medical care delivery and market dynamics.
• Strong written and verbal communication skills.
• Knowledge of health care products and services.
• Problem-solving skills.

Responsibilities

• Establishes and maintains network adequacy for assigned provider types, regions and/or lines of business; SME for provider network contracting and administration.
• Analyzes and proposes formal provider reimbursement recommendations within budgets and strategies.
• Collects, interprets data to support contracting activities; applies contract terms and regulatory requirements.
• Prepares and presents information, findings, and recommendations to stakeholders.
• Liaises with stakeholders to coordinate work items; tracks progress with qualitative and quantitative measures.
• Engages in provider contract negotiations with providers and leadership.
• Assists in preparing provider contracts, amendments, and communications.
• Maintains knowledge of regulatory mandates to ensure compliance.
• Responds to inquiries from providers and colleagues; leads issue resolution.
• Maintains high standards of integrity and privacy; supports corporate values.
• Performs other functions as assigned by management.

Skills

Provider reimbursement

Contract negotiation

Financial modeling

Regulatory knowledge

Communication

Education

Bachelor's in health care admin

Job description

Univera Healthcare in Rochester, NY is seeking a network contracting and administration professional who will help develop and maintain provider networks, evaluate reimbursement, and negotiate contracts in line with corporate strategy.

The role requires deep understanding of provider types, regulatory requirements, pricing methods, and market trends, with responsibilities spanning data analysis, stakeholder communication, and cross-functional teamwork.