Community Health Group · 16 hours ago
Contract Analyst
Community Health Group is seeking a Contract Analyst responsible for drafting, negotiating, and administering contracts with healthcare providers and vendors. The role involves ensuring compliance with regulatory requirements and optimizing the value of services provided.
Responsibilities
Draft, review, and negotiate contracts with healthcare providers, vendors, and other partners, as assigned by CHG contract management
Ensure contracts align with organizational goals, policies, and regulatory requirements
Collaborate with other departments to mitigate risks and resolve any contractual issues
Coordinates the flow of contracts by receiving, tracking, monitoring and storing contracts and disseminating contract information to appropriate staff; monitoring contracts by keeping a tracking log of all contracts produced, sent out and completed
Maintaining systems/dashboards with updated data elements
Maintain a comprehensive contract management system, ensuring all contracts are up-to-date and accessible
Monitor contract performance, adherence to terms, and timely renewal or termination of contracts
Provide support and guidance to internal teams regarding contract interpretation and implementation
Organizes work by providing administrative support functions including organizing correspondence, minutes, meetings notices and expense reports; reading and routing contracts for review and execution, preparing and routing correspondence; scheduling appointments; collecting information; maintaining departmental policies and procedures; initiating telecommunications; making recommendations to improve communication and efficiency
Stay informed of federal, state, and local regulations affecting managed health care contracts
Ensure all contracts comply with applicable laws and regulations, including HIPAA, Medicare, and Medicaid requirements
Conduct regular audits to ensure contractual and regulatory compliance
Assist with accurate and timely reporting of the provider network to all applicable regulators including but not limited to DHCS, DMHC, CMS and all internal stakeholders
Act as a liaison between the organization and healthcare providers, negotiating mutually beneficial terms
Facilitate effective communication and collaboration between internal departments and external partners
Address and resolve any disputes or issues arising from contract execution
Identify opportunities to improve contract management processes and systems
Implement best practices and innovative solutions to enhance contract administration efficiency
Participate in professional development and stay updated on industry trends and changes
Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change the network to meet Plan goals
All other applicable duties as assigned
Qualification
Required
Associate's degree or vocational/specialized training. Equivalent to a bachelor's degree in business administration, Health Services, or related field
3 years related work experience involving provider services contracts or other forms of business contracts and analytical assignments
Strong understanding of managed health care plans and relevant regulatory requirements
Excellent negotiation, communication, and interpersonal skills
Proficiency in contract management software and Microsoft Office Suite
Exceptional attention to detail and organizational skills
Ability to work independently and as part of a team in a fast-paced environment
Preferred
5 years in health care administration
Certification in Contract Management (e.g., CCCM, CFCM, CPCM)
Experience working with eVIPS and/or QNXT databases
Experience working with government healthcare programs such as Medicare and Medicaid
Knowledge of HIPAA and other healthcare-related regulations