Senior Contract Implementation Analyst (State)

Company: Health Net
Location: Woodland Hills
Posted on: February 1, 2025

Job Description:

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Perform day to day duties and testing of complex contract implementation, including UAT to ensure systems accurately reflect a contract's negotiated terms. Assist with implementation of provider contracts.

• Design new or non-standard configuration of complex contracts, and state benefit/pricing changes
  
  • Monitor state bulletins and banners to ensure timely, accurate submission and implementation of benefit and/or rate changes
    
    • Collaborate with internal audit team to correct identified configuration errors
      
      • Collaborate with internal contracting or configuration to troubleshoot and problem solve complex contract implementation issues
        
        • Develop, communicate, implement and maintain production and quality standards
          
          • Review new and current provider contracts and established state guidelines
            
            • Determine the appropriate configuration of the claims payment process in the appropriate subsystem of the claims payment information system in conjunction with health plan, claims and corporate management and information systems staff
            • Performs other duties as assigned
              
              • Complies with all policies and standardsEducation/Experience: Bachelor's degree in Business, Finance, related field, or equivalent experience. 3+ years of provider contract implementation, contract analysis or claims analysis experience in managed care, health care or TPA setting. Understanding of rate methodology and contract language. Government programs and Amisys experience preferred.Pay Range: $26.50 - $47.59 per hour
                Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
                
                Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
                
                Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Keywords: Health Net, Chino Hills , Senior Contract Implementation Analyst (State), Accounting, Auditing , Woodland Hills, California