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Tahlequah

    Health Contracts Analyst - Tahlequah, United States - Cherokee Nation

    Cherokee Nation
    Cherokee Nation Tahlequah, United States

    3 weeks ago

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    Description

    Job Summary:

    Health Contracts Analyst is responsible for participating in and supporting comprehensive vendor management. These initiatives may include developing and maintaining relationships with payers and vendors with whom Cherokee Nation Health Services contracts. This position works cross-functionally to ensure contracts are processed quickly and completed in their entirety. The analyst should strive for compliance, administrative completeness, and focus on maintaining a positive contractual relationship with payor/vendor partners. Responsible for maintaining and organizing contracting records, as well as, ensuring an efficient review of contracts with our Legal team. This position is key in managing the application and contracting process for new contracts and will work closely with internal departments to maintain compliance. Reviews all areas of the health systems. Routine duties include providing health care services to individuals eligible for services in accordance with the self-governance compact and funding agreement between the Cherokee Nation and the United States executed under the authority of the Indian Self-Determination and Education Assistance Act.

    Job Duties:

    Manages a portfolio of payor/vendor contracts (both new and existing) including understanding the application and contract language, key terms, completing an initial legal and financial review of the contract terms, and owning activities needed to initiate or renew the contract. Performs timely contract administration ensuring accurate recordings of all information to do with the contract itself and sharing with the appropriate interdisciplinary teams. Coordinates preparation and review of contracts/agreements along with supporting documentation in accordance with applicable rules, regulations, and guidelines. Enters requisitions in accordance with policies and procedures to encumber funds for contracted services and/or procurement of supplies and equipment for Health Services. Enters required information and documentation into the acquisition management SharePoint site for the legal review process. Evaluates and/or monitors contractor performance to determine the necessity for amendments or extensions of contracts and compliance with contractual obligations pertinent to Health Services. Prepares contract/agreement modifications and renewals as requested and/or required. Mails/emails contracts to contractors for signature. Routes contracts to the Executive Director, and Principal Chief or designee for signature. Acts as point of contact for contracts/agreements for Health Services. Processes termination notices for all Health contracts in accordance with policy and procedure. Reminds supervisors via e-mail when contractor evaluations are due. Provides health contract training as requested by health service programs. Reviews and prepares third-party resource applications/agreements pertinent to Health Services in accordance with the applicable rules, regulations, and guidelines. Provides assistance and guidance to Health Services Administration to ensure compliance with applicable internal and external policies and procedures. Provides customer service and support to all health programs as needed for contract processes. Reviews and obtains billing numbers for Health Providers and Health Facilities. Processes the re-credentialing agreements for the insurance companies. Prepares miscellaneous reports as requested. Reviews correspondence concerning Health Services contracts and notifies supervisor of any changes. Updates and maintains the health contracts SharePoint status report. Maintains the health contracts executed contract database per DNV accreditation. Maintains the Business Associate Agreement (BAA) database for privacy compliance. Maintains the Coordination of Care (CCA) database for purchased and referred care agreements. Files fully executed contracts and maintains the filing system. Reviews and assures Health Services Programs needs are met in a timely, professional, and friendly manner. Reviews and obtains licenses for Health Providers and Health Facilities as applicable to the specific contracted services. Prepares executed notifications to contractors and health programs. Other duties may be assigned.

    SUPERVISORY RESPONSIBILITIES

    No supervisory responsibility.

    Qualifications:

    EDUCATIONAL REQUIREMENT

    Associate's degree from a 2-year college or technical school; or two (2) years (60 credit hours) coursework from a 4-year college or university; or three (3) years of related experience; or an equivalent combination of education and experience.

    EXPERIENCE REQUIREMENT

    At least three (3) years of experience in a related field.

    COMPUTER SKILLS

    An individual should have knowledge of Contact Management software, Database software, Spreadsheet software, Word Processing Software.

    CERTIFICATES, LICENSES, REGISTRATIONS

    None required.

    OTHER QUALIFICATIONS

    The employee must not be and will not be under sanction by the United States Department of Health and Human Services Office of the Inspector General (OIG) or by the General Services Administration (GSA) or listed on the OIG's Cumulative Sanction Report, or the GSA's List of Excluded Providers, or listed on the OIG's List of Excluded Individuals/Entities (LEIE).

    PHYSICAL DEMANDS

    While performing the duties of this job, the employee is regularly required to sit. The employee is frequently required to talk or hear. The employee is occasionally required to stand, walk, use hands to finger, handle or feel, reach with hands and arms, stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 25 pounds.

    WORK ENVIRONMENT

    The noise level in the work environment is usually moderate.



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