Job type full-time
Full job description
Optum is seeking a senior contract analyst to join their team full timeThis is a fully remote position, but must be able to work pacific time 7:00am-4:00pm or 8:00am - 5:00pm.
The payor contracting team supports negotiating agreements which benefit the washington payor contracts for the entire regionThe senior contract analyst is responsible for managing document control, redlines, reviews, inserting key terms and converting negotiation notes into document languageIn addition, supporting negotiations, distributing function specific contract language for approval and routing final documents for signatureDevelops tools (e.gDashboards, grids, tables, summaries) needed to provide organizational leadership key contract data.
Essential duties & responsibilities
Maintains and updates scanned contracts and related documents on the appropriate drive.
Circulates draft contract terms/language to appropriate internal departments for review & approval.
Identifies material changes to contracts and works with the legal team to respond to these issues.
Provides contract insight to the business office and claims shop to ensure accurate and efficient loading of contracts and claims payment.
Answers and/or resolves urgent inquiries from health plans or internal departments in a timely manner
Researches claim or benefit inquiries as needed.
Establishes good working relationships with health plan representatives, as well as internal staff.
Develops tools (e.g., dashboards, grids, tables, summaries) needed to provide organizational leadership key contract data.
Ensures proper representation at outside meetings and/or joint operations meetings as needed.
Completes special projects and other assignments on as needed basis, and as assigned.
Applies knowledge of managed care, health laws, and the knox-keene act in developing contracting strategies and solving problems.
Keeps abreast of industry trends, anticipates implications and opportunities, and collaborates with the management team in developing and managing work plans for payor contracting activities.
Reviews health plan contract language, and is familiar with payor, medical group/ipa, and hospital contract language and reimbursement mechanisms.
Leads contract negotiations, as assignedThis may include, but is not limited to, fee-for-service negotiations with ppo’s, asc’s, ucc’s etc.
Other duties as assigned.
Knowledge, skills and abilities
Ability to make independent decisions.
Ability to interact with health plan partners, providers, and teammates.
Must be able to change thought patterns quickly.
Ability to multitask.
Advanced msword capabilities: find & replace, redlining, comment insertion, track changes and document compare.
Proficient in msexcel and powerpoint software.
Bachelor’s degree in business, healthcare administration or related field required.
Unitedhealth group requires all new hires and employees to report their covid-19 vaccination status.
Full covid-19 vaccination is an essential requirement of this roleUnitedhealth group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
2 years or more experience in health plan managed care contracting/contract administration.
Prior experience with capitation and risk sharing arrangements.
Prior experience with government programs (medicare, medicaid)
Prior experience working with health plan counterparts.
Office equipment, computer, personal vehicle
Posted 30+ days ago