Provider Network & Geo-Access Analyst

Socket.dev; Linthicum (MD); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care’s statewide provider network of hospitals and physicians.

The role focuses on evaluating contracts, applying reimbursement principles, and coordinating with departments to implement efficient and compliant agreements. The position involves leading a team of Provider Data Coordinators, ensuring regulatory reviews, and maintaining network coverage through Geo Access reporting and analysis.

Qualifications

• Ability to review and comprehend contracts and services.
• Ability to present information effectively to providers and employees.
• Strong problem-solving, data analysis, and action planning abilities.
• Excellent organizational and coordination skills.
• Experience with Geo Access or similar systems is required.

Responsibilities

• Evaluates current contracts, and applies managed care reimbursement principles to identify cost savings while maintaining quality.
• Researches contract procedures and coordinates with departments to streamline processes.
• Coordinates implementation of new contracts with involved departments.
• Coordinates internal review and determine/evaluate administrative feasibility throughout contracting process.
• Initiates contract flow process; ensures signatures and data entry are completed.
• Acts as team lead and trainer for Provider Data Coordinators.
• Ensures legal/regulatory review of contracts prior to execution.
• Monitors provider availability and accessibility to ensure network coverage.
• Creates and reviews Geo Access reports and makes recommendations for future network build-out.
• Assists with onsite contractual reviews; ensures data accuracy in provider files.

Skills

Contract review

Contract negotiation

Data analysis

Geographic analysis

Presentation skills

Microsoft Office

Education

Bachelor’s degree in business/health/management systems

Tools

Microsoft Office Suite

Job description

Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care’s statewide provider network of hospitals and physicians.

The role focuses on evaluating contracts, applying reimbursement principles, and coordinating with departments to implement efficient and compliant agreements. The position involves leading a team of Provider Data Coordinators, ensuring regulatory reviews, and maintaining network coverage through Geo Access reporting and analysis.