Provider Contract Specialist

4 weeks ago

Miami, United States Palm Medical Centers Full time
Job DescriptionJob Description

The Payor Contract Analyst will support payor negotiations and strategic decisions with existing payor relationships through financial modeling and analysis.

Job Functions:

  • Evaluate the profitability of new and existing payor contracts by extracting, analyzing, and interpreting complex data.
  • Maintain all payor agreements and amendments and communicate relevant changes and financial impacts to leadership.
  • Work with various data extracts and formats to perform comprehensive financial reconciliations of payor inputs.
  • Collect and analyze payor data sets to identify discrepancies, irregularities, or other material changes to financials and communicate findings to relevant stakeholders.
  • Create, maintain, and share list of strategic initiatives with projected financial values and manage the process through completion.
  • Collaborate cross functionally both internally and externally to ensure key deliverables are delivered timely and that all initiatives are completed timely and accurately.
  • Audit and monitor all payer files needed for analytics on an ongoing basis for completeness and accuracy communicating any changes or discrepancies identified to the appropriate stakeholders monitoring updates through completion.
Experience and Skills:
  • 3-5 years of financial analytical experience in managed care/physician group setting.
  • Bachelor’s degree in business administration (Finance, Economics, Accounting preferred).
  • Advanced Excel skills including translation of files and use of complex formulas and pivot tables.
  • Intermediate SQL knowledge (preferred but not required).
  • Ability to translate financial results into summarized power point presentations with charts and other visuals.
  • Ability to work independently in a fast-paced and changing environment, managing priorities and meeting deadlines without close supervision.
  • Excellent collaboration and communication skills including the ability to discuss complex financial healthcare topics and financial findings in concise manner both verbally and written.
  • Strong knowledge of managed care with emphasis on Medicare Advantage population.

Pay: Starting at $80,000 (negotiable based on experience)Palm Medical Centers is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Medical Centers makes hiring decisions based solely on qualifications, merit, and business needs at the time.

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