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Managed Care Operations - Analyst Payor Partnerships

ArchWell HealthNashville, TN

Overview

Schedule
Full-time
Career level
Senior-level
Remote
On-site
Benefits
Career Development

Job Description

Job Summary:The Analyst, Payor Partnerships will play a key role in supporting payor relationships across ArchWell Health. This will be a colleague who is motivated by building internal and external relationships, solving complex problems, conducting root cause analysis, and driving toward resolution. They will support payor relationships and the operational functions related to payors such as quality, revenue cycle, and contracting. An ideal candidate will have exceptional relationship building, problem-solving, and organizational skills, with an interest in growth within healthcare operations.Duties/Responsibilities:

Support payor contracts, payor relationships, provider data management and directory maintenance.Coordinate payer communications and operational updates, including file distribution, provider network communications, network news, calendars, and contact lists.Manage payer portal access, enrollment, and disenrollment across multiple payer platforms.Facilitate operational processes, including payer updates, market communications, and distribution of required materials.Structure analytical results in an organized, visual manner to tell a meaningful, actionable story to cross-functional stakeholdersInterpret contractual language with a clear understanding of business rules for VBC contractingExecute other duties and special projects as needed, focusing on knowledge and skills development

Required Skills/Abilities:

In-depth knowledge of provider network operations from a payor perspective and experience driving successful relationships between carriers and providersWorking knowledge of credentialing, provider data management, provider directories, Medicare Advantage, and membership attributionProject management and communication skillsDemonstrated ability to conduct independent research and present solutions to complex problemsAbility to work both collaboratively and independently to complete complex analyses, leading to actionable strategic and financial business decisionsStrong communication skills with the ability to explain complex problems succinctly and effectively for all levels of leadershipAbility to establish trusting, professional relationships with internal, senior stakeholders

Minimum Qualifications:

Bachelors required and 2-5yrs of experience, or high school diploma and 8yrs of experienceExpertise in MS Excel, including proficiency using formulas, PivotTables, graphing and other reporting and presentation featuresProject management and communication skillsExperience in consulting, managed care, and/or healthcare provider/payer settings (preferred)Embodies and serves as a role model of ArchWell Health's Values:

Be compassionateStrive for excellenceEarn trustShow respectStay resilientAlways do the right thing

About ArchWell Health:

At ArchWell Health, we're creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard, listened to, and given ample time by their physicians to live well later in life.Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood centers where older adults can feel at home and become part of a vibrant, wellness-focused community. We're passionate about caring for older adults and united by the belief that caring has the power to change everything for our members.

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.

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FAQs About Managed Care Operations - Analyst Payor Partnerships Jobs at ArchWell Health

What is the work location for this position at ArchWell Health?
This job at ArchWell Health is located in Nashville, TN, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at ArchWell Health?
Employer has not shared pay details for this role.
What employment applies to this position at ArchWell Health?
ArchWell Health lists this role as a Full-time position.
What experience level is required for this role at ArchWell Health?
ArchWell Health is looking for a candidate with "Senior-level" experience level.
What benefits are offered by ArchWell Health for this role?
ArchWell Health offers Career Development for this position. Actual benefits may vary depending on the employer's policies and employment terms.
What is the process to apply for this position at ArchWell Health?
You can apply for this role at ArchWell Health either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.