Work with the Contracting Services Manager to develop, design, and generate reports to monitor health care payments, rates and financial impact analysis of UHA’s provider contracts.

• Extract, analyze, and trend health care payment data and other pertinent data to support the functions of the Contracting Services department.
• Complete rate proposal impact analysis for custom contracts.
• At the direction of the Contracting Services Manager, assist the creation of and analyze rate increase options for standard fee schedule update.
• Support payment policy development processes.
• Perform research as requested by the Contracting Services Manager.
• Develop, maintain, and revise modules related to contracts, fees, and codes in the UHA claims processing system.
• Coordinate auditing process of contracts and fees within UHA claims processing system.
• Coordinate Physician Fee Schedule updates.
• Coordinate process to assign rates in UHA claims processing system for newly created codes.
• Coordinate cyclical fee updates for vaccines and other to-be-assigned codes.
• Assign fees in the UHA claims processing system based on contract terms for services on pended claims as needed.
• Maintain monthly reporting required for vendor partners.
• Coordinate projects as assigned.
• Other duties as assigned by Contracting Services Manager.
• This Position prohibits any activity that requires interpretation of clinical information to customers, including the choosing of a set of criteria to use for handling a request for healthcare services or treatment.

The individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Two (2) years’ experience managing and working with large data sets, building databases, querying, generating reports, and analyzing health plan data, statistics, costs, trends and metrics

• Proficiency in Microsoft Word, Outlook and other Microsoft programs including experience with Microsoft Operating System PC computer
• Able to plan, analyze, and implement complex projects with a minimal supervision
• Must have good written communication skills to document the department’s policies and procedures

• Bachelor degree from accredited educational institution
• Three (3) years database reporting tools skills with strong data extraction skills and extensive reporting experience
• Three (3) years of health plan experience and familiarity with claims, authorizations, providers, and membership data

• Excellent data management, analytical and problem solving skills
• Able to use and manipulate large sets of data to enable informed, evidence based decisions
• Great accuracy and attention to detail
• Sound, pragmatic judgement with analytical approach and excellent time management abilities
• Self-motivated with the ability to work independently as well as collaboratively when part of a team

• This position is eligible to work from home with supervisor approval
• Requires operation computer workstation, including keyboard and video display terminal.
• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Competitive compensation & excellent benefits offered

Visit our website at https://uhahealth.com/page/career-opportunities to apply and for details about vacant positions.

An Equal Opportunity Employer