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Contract Analyst - Provider Network, Geisinger Health Plan (resident Mid-Atlantic United States)
<p style="text-align:left"><b>Location:</b></p>Work from home (Pennsylvania)<p style="text-align:inherit"></p><p style="text-align:left"><b>Shift:</b></p>Days (United States of America)<p style="text-align:inherit"></p><p style="text-align:left"><b>Scheduled Weekly Hours:</b></p>40<p style="text-align:inherit"></p><p style="text-align:left"><b>Worker Type:</b></p>Regular<p style="text-align:inherit"></p><p style="text-align:left"><b>Exemption Status:</b></p>Yes<p style="text-align:inherit"></p><p style="text-align:left"><b>Job Summary:</b></p>Oversees the development, review, and maintenance of provider network contracts to ensure compliance with regulatory, policy, and organizational standards. Supports the strategic development and sustainability of provider networks through contract preparation, amendments, and provider communications. Accountable for performing provider and network analysis to support contracting and administration activities. Serves as a subject-matter resource by resolving provider and internal inquiries related to contracting and network administration, while engaging in provider contract negotiations and applying a working knowledge of reimbursement structures.<p style="text-align:inherit"></p><p style="text-align:left"><b>Job Duties:</b></p><p></p><p>Responsible for development, review and maintenance of contracts according to applicable regulations, policies and standards.</p><p></p><ul><li>Responsible for development, review and maintenance of contracts that (i) comply with applicable regulations, policies and standards; and (ii) contain complete and accurate terms and conditions of a business relationship that benefit the System by identifying, reducing, shifting or eliminating risk using department standards, professional discretion and independent judgment.</li><li>Identifies and notifies management of potential operational, legal and financial issues and recommends alternatives throughout document development.</li><li>Develops and manages the maintenance of contract template documents and/or reference materials to be utilized as an initial foundation to assist in the generation and review of commonly requested agreements and coordinates managing and maintaining accurate records of important contracting reference materials.</li><li>Maintains precise documentation of contractual records and retention of resolutions for future situations.</li><li>Manages all database requirements with respect to contracts.</li><li>Monitors contract anniversaries for renewal and coordinates the renewal with the departments and any recommended or department requested renegotiation.</li><li>Provides accurate inventory and filing of current and pending contracts awaiting completion.</li></ul><p><br>Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Bachelor’s Degree = 2 years).</p><p></p><p>#LI-REMOTE</p><p style="text-align:inherit"></p><p style="text-align:left"><b>Position Details:</b></p><p style="text-align:inherit"></p><p style="text-align:left"><b>Education:</b></p>Graduate from Specialty Training Program- (Required), Associate's Degree- (Preferred)<p style="text-align:inherit"></p><p style="text-align:left"><b>Experience:</b></p>Minimum of 2 years-Relevant experience* (Required)<p style="text-align:inherit"></p><p style="text-align:left"><b>Certification(s) and License(s):</b></p><p style="text-align:inherit"></p><p style="text-align:left"><b>Skills:</b></p>Analytical Thinking, Communication, Customer Service, Healthcare Regulatory Environment, Legal Analysis, Legal Writing, Multitasking, Teamwork<p></p><p><b>OUR PURPOSE & VALUES: </b><span>Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. </span></p><ul><li><b>KINDNESS: </b><span>We strive to treat everyone as we would hope to be treated ourselves. </span></li><li><b>EXCELLENCE: </b><span>We treasure colleagues who humbly strive for excellence. </span></li><li><b>LEARNING: </b><span>We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. </span></li><li><b>INNOVATION</b><span>: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.</span></li><li><span><b>SAFETY:</b> We provide a safe environment for our patients and members and the Geisinger family. </span></li></ul><p></p><p></p><p>We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.</p><p></p><p><span>We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.</span></p>