Supports the medical cost position of assigned markets through analysis of healthcare provider contracts, analysis of high performing network solutions, analysis of medical expense reports, data drill downs of trend drivers, and execution of key initiatives designed to address medical expense and product pricing trends.
Partners with network management and pricing units to deliver medical expense results in line with trend/cost expectations to ensure strong competitive positioning within the marketplace.
Provide analytical and strategic support of health care provider rate negotiations.
Identify opportunities for medical cost reduction, develop action plans, and drive execution.
Assess the cost and quality efficiency of health care providers.
Collaborate with local network team to develop and maintain high performing network solutions.
Assess competitiveness of standard and high performing network products.
Analyze reports and present findings to business partners at various levels of the organization.
Support business partners and team members on an ad hoc basis as needed to support various integral business needs.
Maintain strong communication with other analysts to identify new opportunities and share best practices.
Mentor/train business partners and other analysts.

Bachelor's degree in Statistics, Mathematics, Economics, Health Policy Analysis, Finance, or other related field of study
Master's degree preferred
5+ years of experience with health care data analysis required
Experience with medical cost trend analysis and health care provider contract analysis preferred
Strong analytical and problem solving skills with a proven track record of success
Ability to independently perform data analysis while managing multiple projects and meeting strict deadlines
Strong ability to validate and interpret results
Ability to influence and drive strategic planning, action plan development, and execution of plans through engagement of business partners, education on key drivers and actionable levers, and thorough understanding of market-level dynamics
Strong communication skills to include written, oral, and group presentation
Understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management
Technical sophistication with various data mining and business intelligence tools such as SAS, SQL, Microsoft Access, or similar products, advanced Microsoft Excel skills
Knowledge of standard medical coding including CPT-IV, ICD-10, DRG, revenue codes, and HCPCS

Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
401(k)
Company paid life insurance
Tuition reimbursement
A minimum of 18 days of paid time off per year
Paid holidays

Senior Provider Contract Analyst

Key skills