Associate Contract Analyst
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:
Assists with managed care contracting activities on behalf of the organization. Assists departmental leadership to maximize contract reimbursements from third party payer agreements. Participates in the development, communication and implementation of financial and operational requirements of third party payer agreements.
Job Requirements:
Education and Work Experience:
- Associate’s/Technical Degree or equivalent combination of education/related experience: Required
- Bachelor's Degree: Preferred
Essential Functions:
- Assists with Analyzing financial and operational data related to managed care contracts for the organization. Assists with researching managed care contract language and methodologies. Reviews, analyzes and monitors contracts while ensuring legal and compliance policies and regulations are followed and met.
- Acts as a liaison for the efficient communication and coordination of day-to-day managed care operational issues related to patient access, claims adjudication and collection, and medical care management.
- Analyzes coding interprets reimbursement. Researches for trends of variances and contacts payers to recover underpayments. Maintains systems and tracks variance statistics. Works with internal stakeholders and external payer representatives to ensure contract compliance and resolution of payment issues.
- Creates and maintains detailed reports for management. Analyzes current payers' contracts for areas of improvement during contract negotiation.
- Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
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Are you looking for an exciting opportunity to join Adventist Health as an Associate Contract Analyst in beautiful Roseville, California? Located in the vibrant Sacramento metropolitan area, Adventist Health boasts a WELL-certified campus designed for you to thrive, whether you're collaborating on-site or working remotely. In this role, your primary focus will be assisting with managed care contracting activities that are vital for the organization's growth and financial success. You'll work closely with departmental leadership to ensure that we maximize our contract reimbursements from third-party payer agreements. Your day-to-day responsibilities will include analyzing financial and operational data, reviewing and monitoring contracts, and acting as a liaison to tackle operational issues around patient access and claims. You're not just crunching numbers; you're part of a mission to enhance patient care by ensuring compliance with legal policies while working towards optimal reimbursement strategies. If you have an Associate’s or Technical Degree (or equivalent experience), and a keen analytical mindset, this could be the perfect fit for you! Bring your passion for healthcare and let’s work together to ensure our patients receive nothing but the best care possible. Join us at Adventist Health, where your contributions will make a real difference in the lives of many!
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