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Contracts Analyst

Ontario, CA, USRemoteFull-time

AI Summary

The Contracts Analyst originates and maintains physician and provider contract packets, tracks submission and approval processes, and amends contracts for the self-funded medical plan (EPO).

About this role

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities

The Contracts Analyst originates and maintains physicians and providers contract packets, Letter of Agreements (LOA), tracks submission and approval process, maintains and updates contact files and amends contracts as appropriate for the self-funded medical plan (EPO). Requires a high level of responsibility, confidentiality, judgment and discretion in applying department policies, procedures and handling confidential information. Communicate effectively, in writing, verbally and via telephone. Expand our network of providers, and make recommendation for management for lacking or contracted providers within Prime network. Performs special projects as assigned by the Corporate Director of Employee Health (EPO).

Qualifications

Required qualifications:

  • High School Graduate or GED.
  • Working Knowledge of physician credentialing process, and strong follow-up skills.
  • Knowledge of CPT, ICD-10 codes, Medicare guidelines, and Managed Care contracts.
  • Working knowledge of self-funded medical plans and/or Managed Care plans.
  • Computer literate in Microsoft Office Windows.
  • Ability to interact professionally with physicians and vendors.
  • Preferred qualifications:

  • Associate's degree from an accredited institution.
  • Pay Transparency

    Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $24.77 to $28.25. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

    Employment Status

    Full Time

    Shift

    Days

    Equal Employment Opportunity

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

    Privacy Notice

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

    Skills

    CPT CodesICD-10 CodesManaged Care ContractsMedicare GuidelinesMicrosoft OfficePhysician CredentialingSelf-funded Medical PlansWindows

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