Contracting Analyst in Orange at Prospect Medical Systems

Date Posted: 7/29/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    600 City Parkway West
    Orange
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    7/29/2019
  • Job ID:
    13224

Job Description



Contracting Analyst

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The Contracting Analyst is responsible for managing the Provider Contracting Capitation Leakage deduction process. This position will also Negotiate and draft agreements and amendments as needed.  In addition, this analyst will also develop and present a data analytics training course for the contracting team. 



Job Responsibilities/Duties

  • Review Monthly Leakage data for quality, accuracy and to determine the validity as a capitation deduction.
  • Develop Policies and Procedures to support the PCCLD process
  • Monitor and modify all aspects of the PCCLD process to ensure successful execution of PCCLDs.
  • Participate and provide guidance in all company efforts to ensure data integrity and discipline with regard to contracting data.
  • Negotiate and draft agreements and amendments outlining contractual terms.
  • As directed by Contracting Directors, support and/or lead contracting negotiations with providers: PCPs, Specialists, Ancillary Hospitals, or Health Plan.
  • Develop and present managed care data & analytics training for all contracting team members.
  • Capitation rate calculations.
  • Develop MS Excel acumen to intermediate level for all Contracting team members: Formulas, Functions, and Formatting.


Qualifications

Minimum Education: Bachelor’s degree in Health Care Administration, Business Administration, Mathematics or other related field.

Minimum Experience: Five to seven (5 -7) years of experience in Managed Care contracting role or supporting that role. Five to seven (5 -7) years of experience in an analytical role in Managed Care organization(s). Experience in an IPA, hospital or health plan setting is preferred. Experience with managed health care programs is preferred.

Req. Certification/Licensure: None. 



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance

Prospect Medical Systems has a zero-tolerance policy regarding the use of drugs and alcohol.  Our Company is committed to maintaining a productive, drug free workplace that keeps employees and patients safe from harm.  For this reason, we require applicants to pass a screening for drug use as a condition of employment.  This includes: alcohol, marijuana, cocaine, opiates and methamphetamines.



How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm



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