Contract Management Analyst

The Contract Management Analyst manages and maintains the Master Provider database and subsidiary databases, the Master Contract Negotiation Contact database, and the CMS 4i database.  The Contract Management Analyst coordinates data maintenance in BrainStream and provides all necessary reports from all databases as requested by leadership.  In addition, the Contract Management Analyst provides support to the Executive Administrator regarding daily office operations and projects.

Essential Job Functions

  • Establishes and maintains a master provider database with all required data elements; collects and compiles data from multiple sources; ensures data is current, accurate & complete; updates, adds, deletes and/or modifies data.
  • Maintains a master contract negotiation contact database as received from various networks.
  • Maintains CMS 4i database, contacts providers for updated or missing information, coordinates uploads, downloads, and reports.
  • Reviews communication from CMS including e-mail notifications, training, conference calls and takes action as required.
  • Educates departments on all CMS correspondence, evaluates information received from CMS and either takes the required action and/or coordinates completion of required action by the appropriate department
  • Conducts annual 4i data submissions as scheduled by CMS to include all necessary updates to achieve accurate provider network submissions, and submission of provider-level TCC percentages.
  • Reviews New Provider roster received from the Network Team based on newly signed contracts, adds new provider information to the master provider database, master CMS notices file and the website provider directory.
    • Sends provider F.A.Q.s to newly contracted providers.
    • Sends required CMS notifications to newly contracted providers
  • Reviews monthly rosters received from contracted groups/systems, adds/deletes/modifies existing provider information in the master provider database, master CMS notices file and the website provider directory.
    • Conducts research on all “deleted” care providers from monthly provider rosters, documents the care provider’s new group/network and determines if the group/network is or is not already contracted with ilumed.
  • Compiles a monthly report reflecting the care providers no longer with the contracted group/network.
  • Runs monthly OIG reports, identifies any contracted care providers on the list, notifies groups/networks, and updates all databases / directories as required.
  • Updates all databases to reflect all care-provider changes.
  • Performs general administrative tasks as requested to include maintaining records/files, compiling reports, scanning documents, and scheduling meetings.
  • Provides administrative support on projects and initiatives.
  • Acts as back up for Executive Administrator as needed.
  • Performs other duties as assigned.

Skills and Competencies

  • Advanced Level Excel and other Microsoft Office Suite software
  • Data aggregation software
  • Verbal and written communication
  • Analytical and problem-solving
  • Organizational and time management
  • Accuracy and attention to detail
  • Project management
  • Multi-tasking

Education and Experience

  • Associate’s degree in business or information technology-related field or equivalent experience.
  • Three – five years of experience managing electronic data, preferable in healthcare.

Physical Demands

  • Sitting, standing, bending, reaching and the ability to mobilize throughout the office.
  • Pro-longed work at computer monitors.
  • Lift and/or move up to 10 lbs.

Additional Information

  • Must abide by all HIPAA, Confidentiality & Privacy Laws
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

DISCLAIMER:

Job descriptions are not meant to be all-inclusive and/or the job itself is subject to change. Nothing in this job description restricts ilumed’s right to assign or reassign duties and responsibilities to this job at any time.

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