Senior Provider Contracting Analyst

Purpose: Provide necessary analytical support to the contracting staff by ensuring that all contracts are

successfully implemented, and provide oversight of network transitions. Additionally, this position

will and oversee and support junior staff in analyzing productivity, utilization trends, and

financial data in order to assess and improve outside costs related to network provider contracts.

 

This position upholds Kaiser Permanente's policies and procedures, the Principles of Responsibility,

accreditation standards (if applicable), and applicable Federal, state, and local laws and

regulations.

 

Accountabilities: Lead and support analytical, implementation and file maintenance staff, including but not limited to:

Provide training and support to staff with regard to the verification of work, and increasing the

understanding of their knowledge of the KP delivery system

Participate with Director in hiring and evaluating staff, and development/evaluation of individual

and departmental goals

Facilitate resolution of personnel issues

Provide database research, statistical consultation and industry knowledge to internal and external

clients.

Oversight of the contract implementation and quality assurance processes.

Maintain interactive working relationship with peer departments.

Responsible for communication of contract information to those departments requiring contract

information.

Oversee and participate in the loading of contract/fee schedule terms into all applicable systems.

Ensure the accurate and timely maintenance of the department's provider databases; and that contract

files are adequately maintained and secure.

Carries out job related QA activities as needed.

 

Minimum Requirements: Three to five years of experience dealing with health care analytical problems is required

Experience in retrieving and manipulating data on PC and mainframe systems is required

Prior supervisory experience required, demonstrating effective leadership ability

Proven capability to create and manipulate large databases to extract and report on relevant

information is required

Excellent written and oral communication skills are required.

Posses and maintain excellent working knowledge of industry information systems, database

development and analytic software and tools

 

Minimum Requirements - Education and/or Classes: Bachelor's degree in Business or Health Administration; or equivalent technical certifications/experience

Advanced computer competency required in various software applications, e.g. Excel, Project, Access, etc. Experience with Diamond, Pega, RMS, and Amisys is preferred