Managed Care Operations - Analyst Payor Partnerships

Job Summary:

The Analyst, Payor Partnerships will play a key role in supporting payor relationships across ArchWell Health. This will be a colleague who is motivated by building internal and external relationships, solving complex problems, conducting root cause analysis, and driving toward resolution. They will support payor relationships and the operational functions related to payors such as quality, revenue cycle, and contracting. An ideal candidate will have exceptional relationship building, problem-solving, and organizational skills, with an interest in growth within healthcare operations.

Duties/Responsibilities:

• Support payor contracts, payor relationships, provider data management and directory maintenance.
• Coordinate payer communications and operational updates, including file distribution, provider network communications, network news, calendars, and contact lists.
• Manage payer portal access, enrollment, and disenrollment across multiple payer platforms.
• Facilitate operational processes, including payer updates, market communications, and distribution of required materials.
• Structure analytical results in an organized, visual manner to tell a meaningful, actionable story to cross-functional stakeholders
• Interpret contractual language with a clear understanding of business rules for VBC contracting
• Execute other duties and special projects as needed, focusing on knowledge and skills development

Required Skills/Abilities:

• In-depth knowledge of provider network operations from a payor perspective and experience driving successful relationships between carriers and providers
• Working knowledge of credentialing, provider data management, provider directories, Medicare Advantage, and membership attribution
• Project management and communication skills
• Demonstrated ability to conduct independent research and present solutions to complex problems
• Ability to work both collaboratively and independently to complete complex analyses, leading to actionable strategic and financial business decisions
• Strong communication skills with the ability to explain complex problems succinctly and effectively for all levels of leadership
• Ability to establish trusting, professional relationships with internal, senior stakeholders

Minimum Qualifications:

• Bachelors required and 2-5yrs of experience, or high school diploma and 8yrs of experience
• Expertise in MS Excel, including proficiency using formulas, PivotTables, graphing and other reporting and presentation features
• Project management and communication skills
• Experience in consulting, managed care, and/or healthcare provider/payer settings (preferred)
• Embodies and serves as a role model of ArchWell Health's Values:
• Be compassionate
• Strive for excellence
• Earn trust
• Show respect
• Stay resilient
• Always do the right thing

About ArchWell Health:

At ArchWell Health, we're creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard, listened to, and given ample time by their physicians to live well later in life.

Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood centers where older adults can feel at home and become part of a vibrant, wellness-focused community. We're passionate about caring for older adults and united by the belief that caring has the power to change everything for our members.

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.