Senior Vendor Payment Integrity Analyst

EmblemHealth; New York (NY); On-site; USD 68,000 - 119,000; Full time

Job summary

EmblemHealth in New York seeks an experienced professional to review vendor contracts within Enterprise Payment Integrity. You will analyze trends, perform root cause analysis, and support testing strategies with IT and business units to ensure cost-effective outcomes.

This role requires strong project-management skills, extensive knowledge of healthcare contracting, invoicing, and reporting. You will drive process improvements and help ensure timely oversight of contracts from negotiation

Qualifications

• Bachelor's degree required; master’s preferred.
• 4–6 years in health care contracting and management.
• Strong knowledge of healthcare industry, managed care, and health plan operations.
• Experience managing large, complex contracts.
• Knowledge of accruals, invoicing, and financial reporting.
• Excellent communication and cross-department collaboration.

Responsibilities

• Analyze specific contracts in Enterprise Payment Integrity.
• Serve as SME for each contract to ensure optimal outcomes.
• Evaluate interim workflow feasibility to reduce provider abrasion.
• Coordinate with internal business units on vendor contract issues.
• Document business requirements and change requests aligned to needs.
• Manage end-to-end contract processes and project ownership.
• Review new Payment Integrity contracts and provide input.
• Develop testing strategy with IT and business, and execute test plans.
• Participate in Policy Meetings and Steering Committees.
• Create monthly savings reports and compare to goals.
• Assist budget process with requisitions, PO, and accruals.
• Reconcile monthly invoices against Oracle reports.
• Identify system/process improvements for reporting and savings.
• Apply project management to related initiatives.
• Initiate claims to determine under/overpayments with approvals.
• Identify and recommend new programs and savings opportunities.
• Complete Maestro cases in Payment Integrity queues.

Skills

Project management

Contract management

Communication skills

Financial reporting

Education

Bachelor's degree

Master's Degree (Preferred)

Tools

Microsoft Office

Job description

EmblemHealth in New York seeks an experienced professional to review vendor contracts within Enterprise Payment Integrity. You will analyze trends, perform root cause analysis, and support testing strategies with IT and business units to ensure cost-effective outcomes.

This role requires strong project-management skills, extensive knowledge of healthcare contracting, invoicing, and reporting. You will drive process improvements and help ensure timely oversight of contracts from negotiation