Professional
Position Purpose: Provide analytic support for network performance, unit cost trend, network profiling and evaluation, and contract modeling for current health plans, future business, and new products. Utilize applications and tools to support network performance management reporting and analytic needs.
Evaluate and monitor financial performance of key provider contracts for health plans Perform financial analyses to identify medical cost improvement opportunities to develop and execute contracting action plans to achieve results
Perform contract analysis to support contract negotiations including assisting in development of contract modeling tool
Prepare network performance management reports to monitor and measure unit cost trends and network improvement opportunities
Perform detailed contract analysis for executed contracts to evaluate contract terms and rates are meeting expected targets
Research new business state payment methodologies and identify opportunities to improve unit cost management
Collect data requirements from internal and external analytic customers to prepare financial analysis or develop analytic tool/model
Education/Experience: Bachelor's degree in Business, Finance, Accounting, related field, or equivalent experience. 2+ years of provider reimbursement and analysis, data/contract analysis and data mining or statistics, preferably in the healthcare industry. Intermediate knowledge of Access and Excel applications. Working knowledge of SQL tools, analytical software (SAS, SPSS, etc), and Business Objects/Cognos preferred.
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.
TITLE: Contract Analyst II (Pharmacy Analytics)
LOCATION: Detroit, Michigan
REQNUMBER: 1189596
COMPANY: Network Development & Contracting
POSITION TYPE: Professional