Healthcare Contract Definition Analyst - Hospital
Core
Model and maintain hospital payer contracts within the Contract Manager system to support accurate valuation of hospital claims and patient estimates.
Role type
Senior IC healthcare contract definition analyst
Builds
Hospital payer contract configurations and claim valuation models
Domain
Healthcare administration and payer contracting
Deliverable
production ML models | product features
Required skills
Hospital payer contract modeling, reimbursement methodology analysis, Medicare/Medicaid/Commercial payer rules, claims management, adjudication rules, CPT/HCPCS/DRG/ICD-10 coding, system troubleshooting, regulatory research
Preferred skills
Process improvement, stakeholder collaboration
Technologies
Experian Health Contract Manager, CMS systems, state Medicaid portals
Responsibilities
Analyze and define hospital payer contracts, validate system-generated valuations against client claims, research regulatory sources, respond to support cases, participate in project meetings
Seniority
Mid-level, hands-on IC
