Managed Care Contract Analyst

The Managed Care Contract Analyst is responsible for the day-to-day management, modeling, and performance analysis of payer contracts. This role partners closely with the Director of Managed Care Contracting to support contract negotiations, reimbursement modeling, and ongoing payer performance monitoring. The analyst will interpret complex contract language, identify reimbursement trends and issues, and support revenue cycle optimization initiatives.

• Manage and maintain payer contracts, including inventory of agreements, rate grids, and contract terms.
• Support contract negotiations through data extraction, analysis, and complex reimbursement modeling.
• Model and assess payer reimbursement performance and identify trends in payment practices.
• Identify and assist with revenue cycle reimbursement issues and communicate findings to stakeholders.
• Interpret complex administrative and financial contract language and clearly communicate impacts internally and externally.
• Stay current on payer billing and reimbursement changes and proactively communicate updates.
• Interface with outside vendors and consultants as needed.
• Complete credentialing and re-credentialing applications.
• Ensure accuracy and integrity of contract management systems and data.

• Bachelor’s degree in Business, Accounting, Finance, or Healthcare Management

• 3–5+ years of healthcare managed care or payer contract management experience.
• Strong understanding of payer contract language and reimbursement methodologies.
• Hands-on experience with CPT, ICD-9, and modifiers
• Hospital Medicare and Medicaid fee schedules
• Third-party billing requirements and claim payment methodologies
• Claim system requirements, procedures, and controls

• Advanced proficiency in Excel; working knowledge of Word and PowerPoint.
• Strong analytical skills with high attention to detail.
• Excellent written and verbal communication skills.
• Experience with contract management software or strong technical aptitude to learn quickly.