Managed Care Contract Analyst

The Managed Care Contract Analyst plays a key role in supporting the review, interpretation, and implementation of provider contracts and reimbursement schedules. This position ensures accurate contract configuration, system setup, and validation to support efficient claims processing and provider data integrity.

The ideal candidate brings a solid foundation in healthcare contracting, strong analytical capabilities, and a high level of attention to detail, along with the ability to collaborate effectively across internal teams and external partners.

Roles & Responsibilities

• Build and/or oversee the development of all provider fee schedule types, including pre-contract modeling and post-execution interpretation.
• Manage end-to-end facility and ancillary data entry and maintenance to ensure accurate setup for claims payment, member assignment, and directory display.
• Audit provider configurations to ensure contract terms and demographic data are accurately loaded.
• Ensure accurate contract loading and validation of all provider agreements.
• Support the development and standardization of contract and fee schedule processes.
• Partner closely with pricing software vendors to support timely project delivery.
• Investigate and resolve provider contract and configuration issues.
• Identify trends and recommend process improvements to enhance operational efficiency and mitigate risk.
• Monitor and report on provider data quality to ensure benchmarks are met.
• Develop and maintain job aids; support training coordination as needed.
• Perform additional duties as assigned.

Education and Qualification Requirements

• Bachelor’s degree preferred in Finance, Healthcare, Economics, Business, or a related field; equivalent experience (5 years in provider/healthcare contract management) will be considered.
• 1–3 years of experience in code set management and provider reimbursement methodologies.
• Experience working with pricing and claims systems (e.g., Trizetto, Facets, Network Pricer).
• Strong communication and customer service skills.
• Proven ability to build and maintain effective working relationships.
• Adaptable and responsive in a fast-paced, evolving environment.
• Process-oriented with a focus on continuous improvement.
• Highly organized with the ability to manage multiple priorities and deadlines.
• Self-starter with strong accountability and follow-through.
• Proficient in Microsoft Office tools and SQL-based analytics.
• Commitment to maintaining confidentiality and compliance with HIPAA regulations.
• Ability to comply with all company policies and pass pre-employment requirements.
• Minimal travel required (training or client meetings).
• Detail-oriented, goal-driven professional with a proactive mindset.
• Strong time management and task execution skills.
• Effective communicator who thrives in a collaborative, team-based environment.
• Experience in similar roles with hands-on use of tools such as Excel and Access.

REVELOHEALTH is a new healthcare information company with deep payer and provider operational experience, committed to reduce the cost of collections for everyone in our healthcare delivery system. For over 50 years our healthcare delivery system is plagued by unnecessary high cost of collection, due to the lack of a common technology platform generating transparent information between payers and providers in real-time.

REVELOHEALTH delivers healthcare claim pricing, information transparency, and revenue cycle management solutions within a payer repricing technology platform to both payers and providers to reduce cost of collection for everyone.

We have assembled an experienced operating team of healthcare provider and payer executives with over 200 combined years of healthcare expertise. Our leadership has built successful healthcare companies from inception to maturity in the healthcare payments market, revenue cycle management, and payer plan operations markets.

REVELOHEALTH is the final evolution of our combined previous success in operating health plans, healthcare payments, and revenue cycle management businesses. Visit our website to learn more: REVELOHEALTH.