Found Description
Primary Function / General Purpose of Position
The Managed Care Operations Analyst supports managed care contract operations, negotiation, and compliance activities to ensure accurate reimbursement and adherence to payer agreements. This role is responsible for operational contract administration, fee schedule maintenance, payer policy documentation, analytics support, and issue escalation to managed care leadership.
Essential Job Functions
- Review managed care contracts to ensure alignment with organizational standards, regulatory requirements, and approved contract language frameworks.
- Maintain the contract repository database, ensuring accuracy of contract records, executed agreements, timelines, and updates; serve as internal liaison for system updates and user support.
- Track and document contract terms, reimbursement methodologies, and payer policies; prepare summary analyses for managed care leadership.
- Respond ...