CenterWatch

23 days old

Insurance Contracts Analyst

Kelly Services
El Paso, TX 79940
**Job Description**


Evaluate the effectiveness of contracting strategies, payment methodologies and rates in comparison to budget of quality initiatives

Establish financial benchmarks for provider reimbursement and analyze the impact of contracts submitted by the Health Plans

Manage and modify the process for changes to outcomes analysis reports due to various needs and concerns

Prepare and present information on emerging and industry standard reimbursement methods, competitive information, and national initiatives to management in support of network strategy discussions

Oversee various projects including the design of physician incentives and other contractual arrangements

Maintains divisional provider reimbursement models providing analytic reporting capabilities for contracting staff, contract settlement, incentive pool distribution, and estimation of savings through a variety of proposed contract/reimbursement actions

Perform analyses of Health Plan reimbursements

Develop, export and train Health Plan financial analysts on the use financial modeling tools for provider reimbursement and medical expense forecasting

Assist with formulating and administering organization policies and procedures


**Requirements**


Bachelor s degree in related field or equivalent experience.

Working knowledge of contract management processes, claims processing procedures, reimbursement and payment methodologies, and claims systems requirements and controls.

Solid background of claims billing, medical and hospital

Knowledge of Medicaid benefits and reimbursement process

Experience with statistics and the application of higher- level mathematical models to medical and pharmacy claims data.


**Why Kelly** **** **?**



As a worker today, its up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping
you find whats next is what were all about. We know whats going on in the evolving world of workjust ask the nearly 500,000 people we employ
each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.




**About Kelly** ****



At Kelly, were always thinking about whats next and advising job seekers on new ways of working to reach their full potential. In fact, were a
leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable
a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety
of workstyles, skill levels, and industries around the world.


Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females,
individuals with disabilities, protected veterans, sexual orientation, gender identity. Equal Employment Opportunity is The Law.
Posted: 2019-10-25 Expires: 2019-11-25

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Insurance Contracts Analyst

Kelly Services
El Paso, TX 79940

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