Muab Kev Pabcuam Daim Ntawv Cog Lus Analyst

Thov

Qhov chaw: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Lub Nroog Santa Cruz, California

We have an opportunity to join the Alliance as the Provider Services Contracts Analyst within the Provider Services Contracts team.

HAIS TXOG TEAM

The Provider Services Contracts team manages agreements with our providers. They ensure that providers are aware of their legal requirements and that the Alliance is meeting its contractual requirements for both the Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC).

QHOV CHAW UA HAUJ LWM

The Provider Services Contracts Analyst will oversee the lifecycle of provider contracts, this role ensures compliance and conducts thorough analysis to evaluate solutions. Additionally, it collaborates with stakeholders, provides guidance on policy, and produces reports for external audits and regulatory purposes.

KOJ YUAV TSUM TAU TXAIS RAU

Qhia rau Tus Thawj Saib Xyuas Kev Pabcuam Kev Cog Lus, txoj haujlwm no:

• Processes and tracks routine provider contracts from creation through final execution and ensures legal and regulatory compliance
• Conducts research and analysis on contract terms and language to evaluate solutions and alternatives
• Collaborates with individual stakeholders to provide guidance on Alliance contracting policies and procedures
• Collects and synthesizes data to produce reports for external auditors and state agencies

LUB IDEAL CANDIDATE

• Understanding of payment information and claims exposure is preferred 
• Experienced in filling contract requests and dispatching contracts especially with D-SNP programs for hospital rates
• Proficient in understanding the process from receiving contract requests through validating information through contract systems
• Capable of communicating rate and payment information to providers, explaining and translating financial terms for accurate and consistent system configuration
• Knowledge of how contracts are implemented within systems and the importance of translating contracts effectively, with claims exposure seen as beneficial
• Ability to analyze the impact of contractual amendments, considering timelines and contractual requirements with providers in project settings

YUAV UA LI CAS YUAV UA LI CAS

Nyeem tag nrho cov lus piav qhia txoj haujlwm, thiab cov npe ntawm cov kev xav tau nias ntawm no.

• Kev paub txog:
• Legal terminology and standard contracting agreement structure
• Legislative and regulatory directives
• Cov ntsiab cai thiab kev coj ua ntawm kev pabcuam neeg siv khoom
• The methods and techniques of research, analysis, and reporting
• Some knowledge of the methods, tools and techniques associated with contract development, review, implementation, and management
• Muaj peev xwm:
  • Independently negotiate routine contract provisions within the scope of assigned authority
  • Exercise sound judgment and discretion and recognize issues requiring escalation to management
  • Understand, interpret, and apply contract language legislative and regulatory directives, policies, standards, and guidelines
  • Kawm thiab siv Medi-Cal thiab Medicare cov cai tshwj xeeb thiab cov txheej txheem rau kev cog lus ua haujlwm
  • Learn and apply the principles, practices and issues related to the Medicare Dual Special Needs Plan (D-SNP)
  • Ua kom muaj zog analytical thiab kev txawj tshawb fawb, txheeb xyuas thiab daws teeb meem, txheeb xyuas lwm txoj kev daws teeb meem, thiab ua cov lus pom zoo rau kev nqis tes ua
• Kev Kawm thiab Kev Paub:
  • Bachelor's degree hauv Kev Lag Luam, Kev Kawm Kev Cai Lij Choj, Kev Kho Mob lossis ib qho chaw muaj feem cuam tshuam lossis muaj daim ntawv pov thawj Paralegal
  • A minimum of three years of experience in health services, managed care, contracting or government assistance programs which included experience supporting or performing contract negotiations (a Master’s degree may substitute for two years of the required experience; a J.D. degree may substitute for three years of the required experience); or an equivalent combination of education and experience may be qualifying.

Lwm yam kev qhia

• Thaum txoj haujlwm no txuas nrog rau ib qho ntawm peb lub koom haum Alliance, peb nyob rau hauv hybrid tej thaj chaw deb/hauv-chaw ua hauj lwm ib puag ncig tam sim no thiab peb cia siab tias cov txheej txheem kev xam phaj yuav tshwm sim nyob deb.
• Peb cov chaw ua haujlwm Alliance tau rov qhib dua tom qab kis thoob qhov txhia chaw thiab thaum qee tus neeg ua haujlwm tuaj yeem ua haujlwm puv sijhawm hauv xov tooj, kev tuaj koom ntawm peb lub hlis twg cov xwm txheej thoob plaws hauv tuam txhab lossis cov rooj sib tham hauv chav haujlwm yuav xav tau.
• Raws li qhov xwm txheej ntawm kev ua haujlwm, txoj haujlwm no yuav tsum muaj nyob ntawm qhov chaw, uas yog nyob ntawm kev xav tau kev lag luam. Cov ntsiab lus hais txog qhov no tuaj yeem txheeb xyuas thaum lub sijhawm xam phaj.

Cov nyiaj them tag nrho rau txoj haujlwm no tau teev tseg los ntawm qhov chaw hauv qab no. 

Qhov nyiaj them tiag tiag rau lub luag haujlwm no yuav raug txiav txim siab los ntawm peb qhov kev them nyiaj lub tswv yim, kev tshuaj xyuas ntawm tus neeg sib tw xaiv qhov kev tsim nyog (kev ncaj ncees lossis kev hloov pauv tau hais txog txoj haujlwm, kev kawm lossis kev cob qhia), nrog rau lwm yam (kev ncaj ncees sab hauv, kev ua lag luam, thiab thaj chaw nyob. ).

Apply for Provider Services Contracts Analyst