Senior Contract Analyst

The Sr. Contract Analyst works under the supervision of the Director, Contracting & Reimbursement. The primary functions of this position are to assist with establishing and maintaining the Organization’s payor and vendor contracts, assist in executing the organization’s payor relations annual strategy, timely and accurate payor credentialing and compliance with Medicare, PECOS, NPPES, SoS, and state health and business license requirements. Performs other duties as assigned.

PRIMARY JOB DUTIES

Support the review, edits, negotiations, maintenance, and management of contracts and Contract System for organization’s vendors and payors. 

Update, submit, and maintain payor credentialization in a timely and accurate manner.

Ensure compliance and timely validations with PECOS, NPPES NPI Registry, Medicare, Medicaid, SoS, and state health and business license requirements.

Demonstrates the ability to use time effectively and prioritize assigned duties.

Effectively manages personal work schedule so that the agency operations are uninterrupted.

Demonstrates positive interpersonal relations in dealing with all members of the organization.

Effectively demonstrates the mission, vision and values of the agency on a daily basis.

Maintains confidentiality.

1.0       75%       QUALITY OF WORK:

1.1       40%        Contract Maintenance, Analyst assists Director with:

• Working closely with internal Operations and Clinical teams to ensure accurate execution of contract terms.
• Developing and executing Annual Payor Strategy.
• Reviewing current contracts to ensure terms are in line with the organization’s goals.
• Researching payors in current and new service areas and recommending region payor mix based on outcome of research. 
• Coordinating and preparing documentation required for entering new service areas.
• Communicating any necessary payor changes to supply vendors.
• Maintaining contract tracker and Contract Management tool.
• Preparation for Payor Alignment Meetings and communication updates.

1.2       35%        Agency Compliance and Credentialization, Analyst assists Director with:

• Ensuring payor credentialization occurs timely and accurately to prevent disruption for internal teams.
• Medicare and Medicaid credentialing as needed and as periodically required.
• Preparing Agency initial license applications and annual renewal packages for submission to the applicable State Department of Health and Human Services.
• Preparing Agency state business license applications and annual renewal packages for submission.
• Ensuring NPPES NPI Registry, Secretary of State filings, and PECOS are maintained for all Agencies.
• Requesting Tax EINs as needed for new Agencies.
• Completing JARS and ORS Reporting for South Carolina.

2.0       10%       PRODUCTIVITY:

2.1       10%        Demonstrates the ability to use time effectively and prioritize assigned duties:

• Plans and prioritizes work activities for maximum productivity and efficiency.
• Initiates and completes work assignments accurately in a self-directed manner with minimal need for constant supervision.
• Assures the completion of assignments within the scheduled time.
• Serves on committees and councils as assigned.
• Other duties as assigned by management team.

3.0       5%         ATTENDANCE AND PUNCTUALITY

3.1       5%          Effectively manages personal work schedule so that agency operations are uninterrupted as demonstrated:

• Provides proper notification of absences or tardiness.
• Takes action to prevent and/or minimize recurring absences or tardiness.
• Coordinates and schedules time off with other members of the team to ensure adequate staffing.
• Adjusts personal time schedule when requested to accommodate agency needs.
• Plans ahead so that personal requests for time off do not disrupt the workflow.

4.0       10%       TEAMWORK, MISSION AND VALUES

4.1       10%        Demonstrates positive interpersonal relations in dealing with all members of the organization as demonstrated:

• Communicates in a positive and productive manner.
• Mentor and supports other contracts team members. 
• Demonstrates respect for team members.
• Manages stress and personal feelings without a negative impact on the team.
• Participates in community outreach activities that promote the goals and objectives of the agency.
• Responds to all employees and clients in a courteous, sensitive, and respectful manner.
• Maintains confidentiality in all areas in compliance with the agencies HIPAA policies and procedures. Maintains strict confidentiality in all areas of accounting.

JOB SPECIFICATIONS

Education: Bachelor’s degree preferred.

Licensure/Certifications: None.

Experience: 3-5 years’ experience in contract drafting and/or negotiation preferred.  Home health experience a plus.

Essential Technical/Motor Skills: Proficiency in Microsoft Word, Excel and Outlook required.

Interpersonal Skills: Teamwork and communication skills are essential. Demonstrates positive interpersonal relations in dealing with all members of the team. Attention to detail is required.

Essential Physical Requirements: Varied periods of sitting or standing, walking, lifting, and carrying files, reaching stooping, long periods of data entry.

Essential Mental Abilities: Prioritizing and excellent organizational skills required. Ability to concentrate with large volumes of paperwork and data entry, handle pressure of deadlines, good judgement, ability to follow procedures, ability to work independently and manage time appropriately.

Essential Sensory Requirements: Visual acuity, touch, hearing.

Exposure to Hazards: Office environment, toner for office machines, high pitch of printers and computers

Other – Hours of Work: Minimum 40 hours per week, Typical work schedule 8:00 am – 5:00 pm, Monday through Friday, alternate work schedule approved by Director, Contracting & Reimbursement. Extended work hours may be required during peak workloads or increase in volume.