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Payor Contract Analyst

2 months ago

Troy, United States HarmonyCares Full time

Overview:

HarmonyCares is one of the nations largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health and HarmonyCares Hospice.

Our Mission To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care.

Our Shared Vision Every patient deserves access to quality healthcare.

Our Values The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other.

Why You Should Want to Work with Us

  • Health, Dental, Vision, Disability & Life Insurance, and much more
  • 401K Retirement Plan (with company match)
  • Tuition, Professional License and Certification Reimbursement
  • Paid Time Off, Holidays and Volunteer Time
  • Paid Orientation and Training
  • Great Place to Work Certified
  • Established in 11 states
  • Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today


Responsibilities:

The Payor Contract Analyst is responsible for the organization of all payor contracts throughout the HarmonyCares Continuum of Care, reviewing new contracts, and ensuring the payment integrity of those contracts.

Essential Duties and Responsibilities

  • Maintains an internal payor contract matrix in an organized manner for all applicable departments and business lines within the company to reference
  • Organizes contracts in an easy-to-identify fashion on the network or contracting database
  • Accurately creates, assembles, and communicates all reports, detailed analyses, and trends needed by various internal and external customers
  • Maintains updated contract rates, including yearly changes in governmental rates
  • Identifies over/under payments, market, business, and reimbursement trends for the organization to maximize collections and improve efficiency
  • Updates new rates, or works in collaboration with IT, to update payor rates in appropriate revenue cycle databases
  • Acts as main point of contact for internal questions related to securing new deals, such as current accounts receivable balance, patient counts, and payment history related to that specific payor
  • Reviews initial contract terms, referencing the companys contracting checklist PADU to assist Operations and Finance in determining whether further negotiation is needed or terms are acceptable
  • Reviews contract amendments, providing notes on what has changed and impacts
  • Collaborates with internal departments on their business needs and proactively offers suggestions to increase efficiencies related to contracting
  • Coordinates the submission of all documents necessary to secure a new payor contract, including filling out the required group credentialing package and coordinating executive signatures for an executed agreement
  • Communicates new payor announcements to applicable departments and stakeholders
  • Acts as a gatekeeper of the payor portal administrator spreadsheet to ensure new hires and termed employees have the proper access
  • Acts as the administrator for the Careport referral management, maintaining user access and making description updates to the organizations entity as needed
  • Other duties as assigned


Qualifications:

Required Knowledge, Skills & Experience

  • Associates degree in Business or other related field
  • Experience with filling out group credentialing applications required by health plans as it relates to contract execution
  • Ability to work independently and as a key contributing team member
  • Possess strong analytical and problem-solving skills
  • Ability to communicate with employees, management, and payer representatives in courteous and professional manner
  • Strong knowledge of Excel
  • Base financial acumen and understanding of P&Ls and unit economics
  • Excellent verbal, written, time management, organizational, and interpersonal skills
  • Must have ability to manage multiple assignments concurrently

Preferred Knowledge, Skills & Experience

  • Bachelors degree
  • Certification in payor contracting through MGMA or other association preferred
  • 3+ years of experience in a contract analyst role
  • Home Health & Hospice contracting experience
  • Working knowledge of Value Based Care Programs


Posted Max Pay Rate:
USD $82,525.07/Yr.

Posted Min Pay Rate:
USD $78,595.30/Yr.

Pay Transparency:
Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations.

Notice:

HarmonyCares and HarmonyCares Hospice are not affiliated with Harmony Hospice Care. HarmonyCares Hospice does not conduct business in OH. HarmonyCares Hospice conducts business in MI, VA, WI, TX, IN, IL.