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Contract Implementation Analyst

Company: Centene Coproration
Location: Woodland Hills
Posted on: November 11, 2019

Job Description:

Description: Position Purpose: Perform day to day duties and testing of contract implementation, including UAT to ensure that systems accurately reflect a contract's negotiated terms. Perform audits of provider setup within the provider information system to ensure accurate contract implementation and subsequent claims processing Review and price contract related pends to ensure claims payment accuracy Ensure accurate contract implementation and subsequent claims processing through provider setup, UAT testing, etc. on basic Change Requests (CRs) (i.e.RHCs/FQHCs/fee schedule updates). Troubleshoot and problem solve contract implementation issues related to basic system configuration Review contracts and assign pay classes and applicable provider information based on contract language. If configuration is needed to accommodate a contract, notify the appropriate parties. Assist with the internal communication of all new and revised material contract terms and provisions to all affected departments Review new and current provider contracts and established state guidelines Participate in determining 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

Keywords: Centene Coproration, Los Angeles , Contract Implementation Analyst, Professions , Woodland Hills, California

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