Blue Signal Search
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Our client is a large-scale healthcare provider. They have over 4 decades of experience providing pharmacy, clinical, and nonclinical care to patients both at home and throughout their community. They focus on quality, innovation, and improving their community as a whole. They are hiring a Health Plan Payor Contract Analyst to be a vital support to their finance teams.
As a Health Plan Payor Contract Analyst, you will be the cornerstone of ensuring accurate and compliant payer plan maintenance, including the creation and management of the Payer Master File (PMF). This role requires a deep understanding of payer contracts and their impact on billing and reimbursement processes.
This Role Offers:
• Opportunity to work in a hybrid model, fostering a balance between remote and in-office work dynamics.
• Company with strong financial standing – parent company over many services and brands.
• Over 40+ years of experience and proven industry success.
• Company on the cutting edge of healthcare technology innovation.
• Massive customer base and a nationwide reputation and presence.
• High employee tenure with low red tape culture. They hire professionals and trust their expertise, giving them room to make tangible impacts.
• Maintain, audit, and document a comprehensive list of payer contracts, ensuring their accurate translation and integration into the billing systems.
• Perform thorough validation of contract terms, ensuring correct reimbursement calculations and compliance with contract stipulations.
• Engage in detailed assessment of payer contracts, executing system improvements and revenue-maximizing strategies.
• Work alongside finance teams, to implement effective strategies and support fee schedule negotiations.
• Manage revenue cycle software, troubleshooting issues as necessary.
• Keep abreast of healthcare regulations and reimbursement policies to ensure compliance.
• Generate and assess comprehensive reports to monitor contract performance and identify financial outcomes.
• Bachelor’s degree in Accounting, Business, or a related field.
• Preference for candidates with 3+ years of experience in contract management and reimbursement methodologies.
• Firm understanding of healthcare payer contracts, reimbursement methodologies, and regulatory compliance.
• Background in healthcare revenue cycle software and data analytics tools.
• Exceptional communication skills, adept in negotiation and relationship building.
• Analytical and problem-solving capabilities, with a detail-oriented approach.
• Ability to work both independently and collaboratively within a team setting.
• Experience in contract negotiation and management is advantageous.
About Blue Signal:
Blue Signal is a leading executive search firm specializing in healthcare recruiting. Our healthcare recruiters have expertise in placing high-performing talent in healthcare IT, medical devices, biotechnology, pharmaceuticals, etc. Learn more at bit.ly/3G5DbWr
To apply for this job please visit www.bluesignal.com.