Lead Contract Implementation Analyst
Company: Oklahoma Complete Health
Posted on: November 18, 2023
You could be the one who changes everything for our 28 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, national organization, you'll
have access to competitive benefits including a fresh perspective
on workplace flexibility.
Oklahoma Complete Health, a Centene company, is committed to
providing quality healthcare solutions to transform the health of
At Oklahoma Complete Health, we are community advocates and
change-makers in search of an inclusive culture grounded by our
commitment to work-life balance, competitive compensation, and
continuous career development. Join us and be a part of a
collaborative, growing network of innovative thinkers delivering
solutions at the local level.
Position Purpose: Lead and oversee the implementation all provider
contracts, including any pertinent changes and modifications
applicable to these contracts. Serve as the subject matter expert
on all contract implementation related issues and questions.
Lead and oversee the internal audits of contracts and related files
to ensure compliance with corporate standards related to contracts
and their implementation
Manage the health plan's workflow to assure timely, accurate
submission and implementation of contracts
Participate in provider contracting activities & provide technical
support with internal departments to improve communication and
minimize contract implementation issues/errors
Act as the health plan interface with Corporate Contracting and
other business owners for all questions regarding implementation
and claims accuracy issues
Act as health plan interface on software product
upgrades/implementations which affect contract implementation
Assess state changes in reimbursement and/or benefits and request
appropriate changes to configuration to correctly & timely
implement these changes.
Ensure accurate contract implementation and subsequent claims
processing through post production audits of claims payment,
provider setup, UAT testing, etc.
Develop, communicate, implement and maintain production and quality
Education/Experience: Bachelor's degree in business, finance,
related field or equivalent experience. 4+ years of provider
contract implementation, contract analysis, or claims payment
system experience in managed care, health care, or TPA setting.
Understanding of rate methodology and contract language. Strong
problem solving and analytical skills. Government programs and
Amisys experience preferred.
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Oklahoma Complete Health, Lawton , Lead Contract Implementation Analyst, Professions , Lawton, Oklahoma
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