Note: The job is a remote job and is open to candidates in USA. OB Hospitalist Group provides customized obstetric hospitalist programs and maternal healthcare services. The Managed Care Contract Analyst will support Obtelecare managed care contracting, payer agreement analysis, reimbursement accuracy, and revenue cycle management operations. The role partners with internal and payer teams to analyze contracts, resolve reimbursement issues, maintain documentation, and identify financial and process improvement opportunities.
Responsibilities
- Support managed care contracting strategies for Obtelecare programs, including payer research, opportunity tracking, contract implementation, and agreement maintenance
- Review, interpret, and summarize payer agreements, reimbursement terms, billing requirements, credentialing requirements, payer enrollment details, state-specific provisions, and contract notice provisions
- Evaluate fee schedules, reimbursement terms, payer behavior, underpayments, trends, and variances to support accurate reimbursement and financial performance
- Maintain contract summary sheets, fee schedule crosswalks, payer lists, rosters, contract status reports, workflow metrics, and other contracting documentation
- Partner with Revenue Cycle Management, operations, credentialing, payer enrollment, and payer representatives to resolve escalated claims, reimbursement, and contract interpretation issues
- Create ad-hoc reports and data analyses related to payment trends, denials, payer performance, reimbursement variances, and contract-related opportunities
- Maintain contract-related training materials, reference documents, and process guides to support onboarding and consistent payer requirement interpretation
- Ensure contract documentation, payer information, and Protected Health Information are handled securely and in alignment with company policies and regulatory requirements
Skills
- Minimum of 5 years of experience in managed care contracting, payer relations, provider relations, revenue cycle, or healthcare contracting
- Strong understanding of Revenue Cycle Management, managed care contract language, reimbursement methodologies, payer operations, contract interpretation, and healthcare regulatory considerations
- Ability to analyze complex payer agreements, identify reimbursement or process improvement opportunities, research payer issues, and recommend solutions
- Excellent analytical, organizational, communication, documentation, and follow-up skills with strong attention to detail
- Proficiency with Microsoft Word, Excel, and contract or revenue cycle systems
- Bachelor's degree in business administration, accounting, finance, healthcare, or a related field preferred; equivalent work experience may be considered
- Experience with healthcare analytics, contract modeling, reimbursement analysis, reporting tools, ECHO, data warehouse reporting, or advanced Excel is a plus
Benefits
- A mission based company with an amazing company culture
- Paid time off & holidays so you can spend time with the people you love
- Medical, dental, and vision insurance for you and your loved ones
- Health Savings Account (with employer contribution) or Flexible Spending Account options
- Employer Paid Basic Life and AD&D Insurance
- Employer Paid Short- and Long-Term Disability w Optional Short Term Disability Buy-up plan
- Paid Parental Leave
- 401(k) Savings Plan with match
- Legal Plan & Identity Theft Services
- Mental health support and resources
Company Overview