Contract Information Management Analyst V Must Live on the Island of Oahu

About the Role

This position drives contract data organization and abstraction by identifying and capturing key complex data, reconciling challenging discrepancies, and leading the audit process for corrections of contractor and contract data to support downstream contracting processes. The role involves:

• Leading the review of provider demographic and contract configuration updates, contract rules, rates, and term updates for complex contracts to ensure accurate integration in systems of record.
• Mentoring others to create and/or update provider and contract configuration spreadsheets.
• Conducting advanced analyses of provider and contract data to develop recommendations for improvement initiatives.
• Guiding the implementation of process improvement initiatives to enhance provider and business goals.
• Collaborating with internal and external partners to develop network strategies and improve access to care.

The role also contributes to provider satisfaction by:

• Leveraging advanced knowledge of provider and contracting data to support contract managers on issues related to contract configuration, interpretation, referrals, claims/disputes, billing, payment, reimbursement, directories, and operational issues.
• Ensuring provider requests for information, questions, and problems are identified, documented, and addressed in a timely manner through innovative processes.
• Validating and conducting advanced analyses on provider and contract data to identify trends and support provider compliance.
• Documenting and reporting provider activities and coordinating with stakeholders to ensure compliance with contract terms and conditions.
• Reviewing complex provider and contract data to ensure compliance with state and federal regulations as well as organizational policies and procedures.
• Leading collaboration with stakeholders to ensure proper contract interpretation, operational readiness, and guiding corrective actions as needed.

Responsibilities

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders.
• Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership, and mentors junior team members.
• Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit.
• Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback.
• Models team collaboration within and across teams.
• Conducts or oversees business-specific projects by applying deep expertise in the subject area; promotes adherence to all procedures and policies.
• Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks as appropriate; monitors progress and results.
• Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals.
• Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
• Contributes to data abstraction by identifying and capturing key standard to complex administrative and clinical data elements, such as patient data; reviewing medical records to identify required data for secondary use; leading the review of standard and complex requirements to ensure correct integration (e.g., metric changes).
• Leads the review of information from diverse electronic health records and uploads data to reduce abstraction needs; transfers data as needed for challenging data transfers.
• Manages overall data process and maintenance by leading processes for entering, maintaining, and reconciling data; reviewing and verifying information to ensure accuracy; responding to and directing the team to address standard to complex data requests from various departments.
• Supports or leverages data processing by conducting challenging and advanced data uploads; ensuring verification, organization, and maintenance of data records; leading the reconciliation of complex discrepancies between data sources and escalating issues as needed.
• Ensures completion of corresponding data reports by developing or using reporting data and metrics for internal and expert reports; providing recommendations for improvements; resolving complex reporting issues.

Requirements

• Six (6) years of experience working with provider data or in provider contracting or related experience.
• Two (2) years of experience working in a role requiring high-volume data entry.
• Four (4) years of experience in data analysis.
• Minimum three (3) years of experience in a leadership role with or without direct reports.
• Bachelor’s degree in Business Administration, Health Care, Information Systems, Human Resources, Operations Research, Public Health Administration, or related field AND minimum six (6) years of experience in health care data analysis, relational database management, business process improvement, training delivery, clinical research, or a directly related field.
• OR minimum nine (9) years of experience in health care data analysis, relational database management, business process improvement, training delivery, clinical research, or a directly related field.

Skills

Core Skills:

• Ambiguity/Uncertainty Management
• Attention to Detail
• Business Knowledge
• Communication
• Critical Thinking
• Cross-Group Collaboration
• Decision Making
• Dependability
• Diversity, Equity, and Inclusion Support
• Drives Results
• Facilitation Skills
• Health Care Industry Knowledge
• Influencing Others
• Integrity
• Learning Agility
• Organizational Savvy
• Problem Solving
• Short- and Long-term Learning & Recall
• Teamwork
• Topic-Specific Communication

Functional Skills:

• Applied Data Analysis
• Business Relationship Management
• Compliance Management
• Consulting
• Contract Management
• Data Entry
• Data Integration
• Health Care Reimbursement
• Provider Data Systems/Processes
• Provider Portals Support
• Quality Assurance Process
• Trend Analysis
• Health Records
• Medical Terminology
• Operations Management

Preferred Qualifications

• Registered Health Information Credentials or Administrator certification.
• Master’s Degree or equivalent (or higher) in Business Administration, Health Care, Information Systems, Human Resources, Operations Research, Public Health Administration, or related field.

Schedule

• Full-time, standard worker.
• Scheduled weekly hours: 40.
• Shift: Day (Monday through Friday).
• Working hours: 08:00 AM – 05:00 PM.
• Work setting: Flexible (worker location must align with Kaiser Permanente’s Authorized States policy).

Pay

Pay range: $139,200 – $180,070 per year. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate’s years of relevant work experience, education, certifications, skills, and geographic location.