Senior Medicare Contracts Analyst

Central California Alliance for Health Remote
US - California - Santa Barbara
June 10, 2024

We have an opportunity to join the Alliance as a Senior Medicare Contracts Analyst, internally referenced as Senior Provider Services Contracts Analyst supporting the brand new team focused on recruitment and expansion of our provider network for the Provider Services Department. The Senior Provider Services Contracts Analyst will manage the full lifecycle of provider contracts, ensuring legal compliance, conducting research, serving as a subject matter expert, providing training on contracting processes, and overseeing system administration and data synthesis for the Provider Services Contracts Team

WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Provider Services Contracts Manager, this position:

Processes and tracks routine to complex provider contracts from creation through final execution, ensures legal and regulatory compliance, and conducts related research

Acts as a subject matter expert and resource to Alliance staff and other stakeholders regarding contracting processes and procedures, and provides training to other analysts and Alliance staff

Implements, manages, and serves as system administrator for Provider Services Contracts Team systems and synthesizes data to produce reports

Assists Provider Services Contracts Manager with program activities and special projects

THE IDEAL CANDIDATE

Strong experience in Medicare contracting is essential, particularly for this senior-level position, with the capability to cross-pollinate knowledge within the team

Proficient in processing and tracking provider contracts from initiation to final execution, handling both routine and complex agreements.

Ensures adherence to legal and regulatory compliance standards and conducts pertinent research.

Acts as a key resource and subject matter expert on contracting processes and procedures for Alliance staff and other stakeholders.

Provides training to other analysts and staff members, enhancing organizational knowledge and skills in contracting.

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here

Knowledge of:

The principles and practices of contract negotiation

The methods, tools and techniques associated with contract development, review, implementation, and management

Legal terminology related to contract administration

Knowledge of Healthcare related contracts

Medicare contracts and Medicare related regulations and processes, if assigned to Medicare contract activities

Some knowledge of the principles, practices and issues related to the Medicare Dual Special Needs Plan (D-SNP), if assigned to Medicare contract activities

Some knowledge of value-based contracting, such as pay-for-performance, capitation and population-based, shared savings, and at-risk contracts

Ability to:

Independently negotiate contract provisions within the scope of assigned authority

Independently prepare, proofread and edit contracts

Understand, interpret and apply contract language, complex laws, legislative and regulatory directives, policies, standards, and guidelines

Demonstrate strong analytical and research skills, identify and troubleshoot issues, identify alternative solutions, and make recommendations for action

Learn and apply Medi-Cal and Medicare specific regulations and processes to contract activities

Learn and apply the principles, practices, and issues related to the Medicare Dual Special Needs Plan (D-SNP)

Education and Experience:

Medi-Cal Assignment

Bachelor's degree in Business, Legal Studies, Healthcare or a related field or possession of a Paralegal Certificate

A minimum of five years of experience negotiating and processing contracts from creation through final execution in a healthcare environment (a Master's degree may substitute for two years of the required experience; a J.D. degree may substitute for three years of the required experience); or an equivalent combination of education and experience may be qualifying.

Medicare Assignment

A minimum of five years of experience negotiating and processing contracts from creation through final execution in a healthcare environment, including a minimum of two years of experience negotiating and processing Medicare contracts from creation through final execution;(a Master's degree may substitute for two years of the general healthcare environment experience; a J.D. degree may substitute for three years of the general healthcare environment experience); or an equivalent combination of education and experience may be qualifying.

OTHER DETAILS

While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.

Our Alliance office locations have officially re-opened after the pandemic and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.

Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).
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Read the full job description and apply online on the recuiter's web-site

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