Contract Analyst

Summary

HCA Healthcare, through its Parallon revenue cycle management organization, is seeking a Contract Analyst. The role models managed care contracts, evaluates reimbursement and financial impacts, supports pricing and negotiations, and maintains accurate contract models in collaboration with internal stakeholders.

Responsibilities

• Model managed care contracts using available modeling tools
• Ensure accurate discounts on patient accounts and proper reflection of expected net revenue
• Complete testing of contract models by service line and document accuracy in modeled results
• Perform prospective ("what-if") financial modeling to evaluate proposed managed care contract terms and assess their impact on reimbursement, profitability, trends, and other key financial metrics
• Develop and maintain contract models used to evaluate reimbursement methodologies, support managed care agreements, analyze financial impact, and ensure accurate implementation and ongoing maintenance of contract terms
• Translate contract language and reimbursement methodologies into accurate system models that support operational reimbursement and contract negotiations
• Accurately apply service descriptions, service rules, reimbursement logic, and modeling parameters to ensure contract integrity and consistency
• Perform quality assurance reviews of contract model changes related to rates, factors, and reimbursement methodologies to ensure modeling accuracy, consistency, and compliance with established standards
• Design, develop, and support ad-hoc analyses and reporting initiatives as assigned by leadership
• Utilize data mining and reporting tools to fulfill customer requests and support operational and strategic initiatives
• Monitor the progress of pricing analyses and contract modeling activities, keeping management informed of project status, risks, and outcomes
• Collaborate with Payer Contracting, Revenue Cycle, Finance, and operational stakeholders to resolve contract questions and provide analytical support during contract negotiations and implementation
• Develop responsive relationships with internal customers by providing timely, accurate analyses and maintaining a high level of customer service
• Participate in departmental training and professional development opportunities to enhance technical, analytical, and industry knowledge
• Contribute to continuous process improvement initiatives that increase modeling accuracy, operational efficiency, and reporting capabilities
• Demonstrate commitment to organizational Mission, Values, and Code of Conduct while producing high-quality, accurate work

Skills

• Bachelor's Degree or Undergraduate Degree Required. Equivalent work experience may substitute for education requirements
• Minimum 1+ years of related experience preferred
• Working knowledge of managed care contracting, reimbursement methodologies, and contract modeling preferred
• Experience with Microsoft Office, Excel, relational databases, reporting tools, and contract modeling applications preferred

Qualifications

Must Haves

• Bachelor's Degree or Undergraduate Degree Required. Equivalent work experience may substitute for education requirements

Nice to Haves

• Minimum 1+ years of related experience preferred
• Working knowledge of managed care contracting, reimbursement methodologies, and contract modeling preferred
• Experience with Microsoft Office, Excel, relational databases, reporting tools, and contract modeling applications preferred

Benefits

• Work from Home position
• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan
• Flexible spending accounts
• Preferred banking partnerships
• Retirement readiness tools
• Rollover support and financial wellbeing counseling
• Tuition assistance
• Student loan assistance
• Certification support
• Dependent scholarships
• Partnership with Galen College of Nursing
• Fertility and family building benefits
• Adoption assistance
• Life insurance
• Supplemental health protection plans
• Auto and home insurance
• Legal counseling
• Identity theft protection
• Consumer discounts