Senior Contract Management Analyst

Job Family:

Business Operations

Travel Required:

None

Clearance Required:

None

What You Will Do: It is the responsibility of the Senior Contract Management Analyst to lead as the contract rate loading expert, by providing support to the team accountable for translating payer contractual terms into pertinent parameters loaded into the Contract Management Database, which produces the pricing of expected reimbursement. 

• Monitors the contract inventory for accuracy of the expected reimbursement and proper reflection of net revenue. 

• Oversees the cross referencing of payer insurance plan codes to associated payer contracts ensuring gaps are closed. 

• Perform as principal specialist in rate modeling and analysis projects; will assist with preparing account dataset included in rate analysis, activate pricing of rate model, validate pricing results, and determine projected revenue impacts. 

• Will preserve a skillset of the logic constructed within the Contract Management Database and will contribute to the overall health of the Contract Management tool by maintaining various functions. 

• This position will perform all job-related duties as assigned. 

What You Will Need:

• Requires a Bachelor’s Degree and a minimum of 6 years prior relevant experience or an Associate's Degree and 8 years prior relevant experience. (Relevant experience may be substituted for formal education or advanced degree).

• 6+ years’ experience in contract management/modeling

• Knowledge of Microsoft Word, Access, and strengths within Excel (pivot tables)

What Would Be Nice To Have:

• Managed Care environment; Acute Hospital contract modeling/pricing

• Sound familiarity with managed care payer contracts and product offerings

• Possess effective/accurate oral and written English communication skills

• Capable to identify contractual terms subject to multiple interpretations 

• Accustomed to an organized project structure that affords successful proactive outcomes

• Familiarity with concepts of database management and EDI processes

• General knowledge of hospital-based patient accounting and contract management systems preferred

• Wide-ranging knowledge of medical coding methodologies including Rev Code, ICD-10, CPT, HCPCS, MS DRG, APR DRG, ASC, EAPG and APC

• Understanding of medical billing procedures and forms including UB-04 and HCFA-1500

• Comprehensive knowledge of medical reimbursement methodologies including per diem, case rates, DRG rates, ASC rates, APC rates, fee schedules, EAPG rates, APR DRG rates, Stop loss provisions and Carve-outs

• Working knowledge of medical terminology

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The annual salary range for this position is $68,000.00-$113,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.