Provider Contract Analyst

Position Summary

The Provider Contract Analyst is a key professional role on the contracting team, responsible for managing the end-to-end contracting process for providers (ancillary, professional and facility).

Primary Responsibilities

• Establish a strong community presence by actively building and maintaining collaborative relationships with providers and community leaders through autonomous, regular in-person engagement within your assigned market.
• Manage a dedicated portfolio of contracts with providers (ancillary, professional and facility), independently handling the negotiation process for renewals and new standard agreements.
• Contribute to the overall contracting strategy by managing contract assignments for providers located outside of your primary market as business needs require, ensuring equitable workload distribution and team success.
• Analyze and interpret contract terms, rate proposals, and reimbursement methodologies to determine appropriate action and ensure alignment with organizational standards.
• Solve moderately complex provider inquiries related to contract interpretation, reimbursement, and operational setup, serving as a knowledgeable point of contact.
• Partner with the Provider Partnership Liaisons to ensure a smooth, professional handoff and onboarding for newly contracted providers.
• Owning the integrity of contract data within the contract management system, ensuring accuracy for downstream reporting and analysis.
• Identify and recommend opportunities to improve contracting processes, templates, and workflows to increase efficiency and accuracy.

Qualifications

• Must reside within one of our key markets (e.g., IL, KY, AR, or MO) to facilitate required in-market provider engagement.
• Community Engagement: This role requires regular in-market community presence, with an expectation of at least one day a week dedicated to local, in-person meetings with providers and community partners. The scheduling of this local activity is autonomous and managed by you in partnership with your leader.
• Occasional out-of-market travel (e.g., 2-4 times per year) is also required for mandatory team meetings and may involve overnight stays.
• All approved overnight hotel stays and personal vehicle mileage for business purposes are reimbursable according to company policy.
• 5+ years of relevant experience in a managed care, health plan, or provider organization.
• Practical, working knowledge of provider contract language, reimbursement methodologies, and managed care principles is required.
• Skilled at interpreting contract data and solving moderately complex problems with limited supervision.
• Strong organizational skills and the ability to prioritize and manage multiple competing deadlines.
• Bachelor's degree or equivalent experience required.

Working Conditions

While performing the duties of this job, the employee works in normal office working conditions.

Pay Transparency

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position.

Benefits of working at Lumeris

• Medical, Vision and Dental Plans
• Tax-Advantage Savings Accounts (FSA & HSA)
• Life Insurance and Disability Insurance
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
• Employee Assistance Program
• 401k with company match
• Employee Resource Groups
• Employee Discount Program
• Learning and Development Opportunities
• and much more...

Disclaimer

The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities. Lumeris is an EEO/AA employer M/F/V/D.