The successful candidate will understand the nuances of managed care contracting, analytics ... Provides effective oversight of contract implementation process ensuring all contracts are within ...
The successful candidate will understand the nuances of managed care contracting, analytics ... Provides effective oversight of contract implementation process ensuring all contracts are within ...
The successful candidate will understand the nuances of managed care contracting, analytics ... Provides effective oversight of contract implementation process ensuring all contracts are within ...
The successful candidate will understand the nuances of managed care contracting, analytics ... Provides effective oversight of contract implementation process ensuring all contracts are within ...
The successful candidate will understand the nuances of managed care contracting, analytics ... Provides effective oversight of contract implementation process ensuring all contracts are within ...
The successful candidate will understand the nuances of managed care contracting, analytics ... Provides effective oversight of contract implementation process ensuring all contracts are within ...
Contract and Data Analyst (Managed Care)
$61K - $74K/yr
Responsible for analysis of contracts and performing contract negotiations to include monitoring ... Experience with health plan insurance contracting and reimbursement for providers. Experience with ...
Contract and Data Analyst (Managed Care)
$61K - $74K/yr
Responsible for analysis of contracts and performing contract negotiations to include monitoring ... Experience with health plan insurance contracting and reimbursement for providers. Experience with ...
Contract & Gas Management Analyst I - Detroit, MI
Detroit, MI · On-site
$68K - $82K/yr
Job Summary As a Contract & Gas Management Analyst, you will enter and maintain contracts in a gas ... Provide nomination assistance to customers. * Communicate nomination and confirmation changes with ...
Contract & Gas Management Analyst I - Detroit, MI
Detroit, MI · On-site
$68K - $82K/yr
Job Summary As a Contract & Gas Management Analyst, you will enter and maintain contracts in a gas ... Provide nomination assistance to customers. * Communicate nomination and confirmation changes with ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Grand Rapids, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Grand Rapids, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Ann Arbor, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Ann Arbor, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Traverse City, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Traverse City, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Lansing, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Lansing, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Managed Care Contracting Analyst- Corporate Services (HYBRID)
Midland, MI · On-site
$59K - $71K/yr
Summary The Managed Care Contracting Analyst is responsible for financial modeling and economic ... Collaborate with the contract negotiation team to provide data-driven insights and recommendations ...
Managed Care Contracting Analyst- Corporate Services (HYBRID)
Midland, MI · On-site
$59K - $71K/yr
Summary The Managed Care Contracting Analyst is responsible for financial modeling and economic ... Collaborate with the contract negotiation team to provide data-driven insights and recommendations ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Flint, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Director, Health Plan Provider Contracts (Medicaid / Michigan Health Plan) - Remote in Michigan
Flint, MI · Remote
Utilizes standardized contract templates and VBP/pay-for-performance (P4P) strategies. Develops and ... Strong data-driven decision-making skills, and analytical abilities. Strong organizational skills ...
Departmental Analyst 9-P11 - HS Medicaid and Aging Supports Section
Lansing, MI · On-site +1
$25.85 - $40.51/hr
The MDHHS mission is to provide opportunities, services, and programs that promote a healthy, safe ... contracts; development and implementation of department budget allocation for the contracts ...
Departmental Analyst 9-P11 - HS Medicaid and Aging Supports Section
Lansing, MI · On-site +1
$25.85 - $40.51/hr
The MDHHS mission is to provide opportunities, services, and programs that promote a healthy, safe ... contracts; development and implementation of department budget allocation for the contracts ...
Provider Operations Associate Analyst
Grand Rapids, MI · On-site +1
Operation Analyst must possess strong attention to detail along with business acumen fueled by ... provider contract setup, claims payment, finance, etc. * Manages the repricing of claims for PH ...
Provider Operations Associate Analyst
Grand Rapids, MI · On-site +1
Operation Analyst must possess strong attention to detail along with business acumen fueled by ... provider contract setup, claims payment, finance, etc. * Manages the repricing of claims for PH ...
Operation Analyst must possess strong attention to detail along with business acumen fueled by ... provider contract setup, claims payment, finance, etc. * Manages the repricing of claims for PH ...
Operation Analyst must possess strong attention to detail along with business acumen fueled by ... provider contract setup, claims payment, finance, etc. * Manages the repricing of claims for PH ...
The Senior Provider Service Administrator (SPSA) is the plan representative with key providers and ... Responsible for managing overall activities related to value-based contracts, including analyzing ...
The Senior Provider Service Administrator (SPSA) is the plan representative with key providers and ... Responsible for managing overall activities related to value-based contracts, including analyzing ...
The Senior Provider Service Administrator (SPSA) is the plan representative with key providers and ... Responsible for managing overall activities related to value-based contracts, including analyzing ...
The Senior Provider Service Administrator (SPSA) is the plan representative with key providers and ... Responsible for managing overall activities related to value-based contracts, including analyzing ...
Be Seen First
Financial Analyst Auditor
Warren, MI · On-site
$37 - $40/hr
Must Have Skills: 1. Financial and Contract Analysis 2. Advanced Analytical and Problem solving ... specializes in providing highly skilled staff in technical fields such as engineering, IT, ...
Quick apply
Be Seen First
Financial Analyst Auditor
Warren, MI · On-site
$37 - $40/hr
Must Have Skills: 1. Financial and Contract Analysis 2. Advanced Analytical and Problem solving ... specializes in providing highly skilled staff in technical fields such as engineering, IT, ...
Negotiate and execute provider contracts, conduct high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based, hospitals ...
Negotiate and execute provider contracts, conduct high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based, hospitals ...
Senior Network Contracting Negotiation Manager, Medicaid (Michigan)
Sterling Heights, MI · On-site
$75K - $165K/yr
Negotiate and execute provider contracts, conduct high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based, hospitals ...
Senior Network Contracting Negotiation Manager, Medicaid (Michigan)
Sterling Heights, MI · On-site
$75K - $165K/yr
Negotiate and execute provider contracts, conduct high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based, hospitals ...
Negotiate and execute provider contracts, conduct high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based, hospitals ...
Negotiate and execute provider contracts, conduct high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based, hospitals ...
Provider Contract Analyst information
What is the difference between Provider Contract Analyst vs Claims Analyst?
| Aspect | Provider Contract Analyst | Claims Analyst |
|---|---|---|
| Credentials | Typically requires a bachelor's degree in healthcare administration, business, or related field; certifications like CPC or CPC-H are common | Usually requires a bachelor's degree; certifications like CPC or similar may be preferred |
| Work Environment | Healthcare organizations, insurance companies, or third-party administrators | Insurance companies, healthcare providers, or third-party payers |
| Employer & Industry Usage | Used in healthcare and insurance sectors to manage provider contracts | Used across insurance and healthcare to process and analyze claims |
The Provider Contract Analyst focuses on negotiating, reviewing, and managing provider agreements, ensuring compliance and reimbursement terms. In contrast, the Claims Analyst primarily reviews and processes insurance claims, verifying accuracy and resolving discrepancies. While both roles require knowledge of healthcare billing and insurance processes, their core responsibilities differ significantly within the healthcare and insurance industries.
What are the key skills and qualifications needed to thrive as a Provider Contract Analyst, and why are they important?
What are some common challenges faced by Provider Contract Analysts when negotiating contracts with healthcare providers?
What are Provider Contract Analysts?
Full-time
Medical, Vision, Retirement
Posted 19 days ago
Job description
Lead by example, holding positive and respectful relationships with highly-valued and complex internal and external customers. The successful candidate will understand the nuances of managed care contracting, analytics, managed care payers, delivery system's primarily operations, functions of a revenue cycle, and know where and when it is appropriate to engage senior leaders. The candidate will also understand the latest healthcare trends and leverage their past years of experience to creatively design contracts that add value for Corewell Health.
Lead tactically by helping junior staff with complex contract terms and negotiating techniques to help prepare for successful contract discussions. The successful candidate will also lead administratively by managing internal communications as it relates to the contracting process and tracking success while driving key projects. The candidate will also gather market and competitive intelligence through secondary sources as it relates to payers and providers and health care policy to increase knowledge providing leverage for the department to use in contract negotiations.
Essential Functions- Manages the contract development and negotiations process for delivery system network initiatives. Enters/maintains/oversees current information in the internal contract repository and system contract database. Leads the proactive, methodical management of contracts from initiation through execution, compliance and renewal.
- Creates contracting strategies and deploys techniques that move payers to desired contract terms according to guidelines and preferred language. Provides effective oversight of contract implementation process ensuring all contracts are within required guidelines and financial parameters and timely.
- Leads the drafting, review, negotiation, and execution of assigned payer contracts from start to finish. Develops regular reports on contract milestones and performance; and informs internal customers of activities and progress, through both verbal and written communications. Interfaces routinely with leadership on an independent basis while understanding other political sensitivities.
- Applies critical thinking skills to analyze complex situations, identify root causes, and evaluate alternative solutions.
- Investigates operational, clinical, or administrative issues by gathering relevant data, conducting interviews, reviewing documentation, and assessing system processes.
- Formulates logical, evidence-based conclusions and make sound recommendations to resolve problems or improve outcomes.
- Collaborates with cross-functional teams to develop and implement corrective actions, ensuring alignment with organizational policies and goals.
- Monitors the effectiveness of implemented language and renegotiates as needed.
Required
- Bachelor's Degree or equivalent in Business Administration, Health Care Administration, Finance, Health and Human services or related degree programs.
- At least 10 years of experience within the healthcare system in either a payer or provider capacity in a direct, outward-facing role that includes data analytics
- Relevant experience in finance or contract management
Preferred
- Masters Degree in business administration, health care administration, finance, health and human services
- Experience in a team lead or project management role responsible for personnel and their success
- Experience working with legal staff.
- Skills in best practices for contract negotiation tactics and strategies
- Working knowledge of anti-trust laws
As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.
How Corewell Health cares for you
- Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
- On-demand pay program powered by Payactiv
- Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
- Optional identity theft protection, home and auto insurance
- Traditional and Roth retirement options with service contribution and match savings
- Eligibility for benefits is determined by employment type and status
Primary Location
SITE - Corewell Health Place - 100 Corewell Drive NW - Grand RapidsDepartment Name
Managed Care Contracting - CorporateEmployment Type
Full timeShift
Day (United States of America)Weekly Scheduled Hours
40Hours of Work
8:00 a.m. to 4:30 p.m.Days Worked
Monday to FridayWeekend Frequency
N/ACURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.