What are the responsibilities and job description for the Healthcare Contracts Analyst position at InterMed?
ESSENTIAL FUNCTIONS
- Maintain a comprehensive database of payer contracts, amendments, and related documentation.
- Ensure compliance with contractual terms and conditions.
- Track contract renewal and negotiation timelines, assisting in the preparation of proposals and counterproposals.
- Responsible for data analysis and methodology for payer contract negotiations.
- Analyze reimbursement trends and variances by payer and contract.
- Develop and own the budget, forecasting and tracking of all non-FFS payments including PMPM, quality incentives and shared savings.
- Develop and maintain financial models to evaluate contract performance and identify opportunities for improvement.
- Review and validate interim and year-end financial settlement reports from payers.
- Provide detailed reports and insights to senior leadership on payer performance and profitability.
- Partner with internal teams (e.g., Business Intelligence, Contracting, Finance and Revenue Cycle) to address reimbursement issues and implement solutions.
- Establish relationships with government and commercial health plans to proactively capture upcoming changes to reimbursement and resolve emerging issues including disputes and escalating issues as necessary.
- Support contract negotiation efforts by providing data-driven recommendations.
- Monitor payer policies and government regulations to identify potential impacts on reimbursement and operations.
- Work with Healthcare Contracts Administrator to address any discrepancies or risks.
- Identify opportunities to improve contract management processes.
- Stay informed of industry trends, reimbursement models, and payer policies.
- Participate in payer education initiatives to improve understanding across the organization.
JOB REQUIREMENTS
- Bachelor’s degree in healthcare administration, business, finance, or a related field (Master’s degree preferred).
- 3 years of experience in payer contracting, healthcare finance, or a related area.
- Subject matter expertise in payor contracts and reimbursement methodologies, health plan operations, and/or claims processing
- Strong analytical and financial modeling skills.
- Proficiency in Microsoft Excel and data visualization tools (e.g., Tableau, Power BI).
- Knowledge of healthcare reimbursement methodologies, including fee-for-service, capitation, and value-based payment models.
- Excellent written,verbal communication skills and attention to detail.
- Strong organizational and project management skills. Ability to coordinate multiple tasks, set priorities, and meet deadlines
- Ability to interpret complex contract language and translate it into actionable insights.
- Experience with payer contract negotiation and dispute resolution.
- Familiarity with payer policies and regulations, including Medicare and Commercial.
Preferred Qualifications:
- Experience querying data directly from a data warehouse using SQL
- Experience working with healthcare claims including ICD-10 and CPT coding
- Experience with electronic healthcare records
- Experience creating dynamic financial models
InterMed is an equal opportunity workplace and prohibits discrimination or harassment of any kind. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, gender identity and/or expression, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law
