Contract Implementation Specialist/Analyst - Riverboat Road Suite Taylorsville, Utah, United States
15 hours ago
Job description
DescriptionPosition Summary
The Contract Implementation Specialist & Analyst is responsible for the successful end-to-end implementation, maintenance, and optimization of payer contracts across the organization. This role ensures that all contract terms—financial, operational, and clinical—are accurately translated into actionable guidance and systems used by Billing/RCM, Intake, Operations, Clinical Operations, and other downstream teams.
This position serves as the primary owner of contract implementation accuracy, the first line of triage for payer-related issues, and the central driver of contract change communication and fee schedule management. The role blends strong analytical skills with cross-functional coordination and clear, structured communication.
Key Responsibilities
Contract Implementation & Operational Enablement
- Lead the implementation of new payer contracts by translating contract terms into clear, actionable requirements for Billing/RCM, Intake, Operations, Clinical Ops, and other stakeholders.
- Ensure all contract components (fee schedules, covered services, site-of-care requirements, billing guidelines, etc.) are fully understood and operationalized.
- Coordinate with internal teams to confirm readiness prior to contract go-live.
Fee Schedule Management
- Own all payer fee schedules, including setup, validation, updates, and version control.
- Manage the cadence of fee schedule updates (quarterly, annual, or ad hoc) and ensure alignment with contract terms.
- Maintain fee schedule source-of-truth resources and support downstream billing system updates.
Payer Issue Triage & Escalation Management
- Serve as the first line of support for payer-related issues impacting operations, billing, or intake.
- Triage issues, assess root cause, and manage escalations.
- Engage the appropriate Account Manager, Contracting Lead, or Credentialing Specialist to support resolution as needed.
- Track issues and outcomes to identify trends and improvement opportunities.
Contract Change Management & Communication
- Act as the primary driver of communication for all contract updates, amendments, and renegotiation outcomes.
- Develop clear, timely, and accurate communications tailored to impacted departments.
- Maintain and update all contract-related resources to ensure ongoing accuracy and reliability.
Data Analysis & Impact Reporting
- Support contract renegotiations by analyzing fee schedule changes, reimbursement impacts, and operational implications.
- Produce reports that summarize financial and operational impact of contract changes.
- Partner with leadership to support decision-making through data-driven insights.
Resource & Documentation Management
- Maintain contract implementation documentation, playbooks, and reference tools.
- Ensure all internal resources reflect the most current contract terms and payer requirements.
- Support continuous improvement of implementation processes and tools.
Qualifications
- Bachelor's degree in Healthcare Administration, Business, Finance, or a related field (or equivalent experience).
- 3–5 years of experience in payer contracting, contract implementation, revenue cycle, or healthcare operations.
- Strong understanding of payer contracts, fee schedules, reimbursement structures, and operational workflows.
- Experience working cross-functionally with Billing/RCM, Intake, Operations, and Clinical teams.
- Advanced Excel and data analysis skills; experience with contract management systems preferred.
Key Competencies
- Exceptional attention to detail and accuracy.
- Strong analytical and problem-solving skills.
- Clear, structured communicator with the ability to translate complex contract terms into operational guidance.
- Highly organized with strong ownership mindset.
- Ability to manage multiple priorities and escalations in a fast-paced environment.
- Proactive, solution-oriented approach to payer and contract challenges.
Success in This Role Looks Like
- Contracts are implemented on time, accurately, and with minimal downstream issues.
- Fee schedules are reliable, current, and trusted across the organization.
- Departments receive clear, timely communication and know exactly how to operationalize payer requirements.
- Payer issues are triaged efficiently, escalations are well-managed, and root causes are addressed.
- Leadership has clear visibility into the impact of contract changes.
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