Contract Definition Analyst - Hospital Definition Specialty

Contract Definition Analyst - Hospital Definition Specialty

The Role

The Hospital Contract Definition Analyst plays a critical role in the implementation and maintenance of hospital payer contracts within client's Contract Manager system. This position ensures accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates.

The analyst collaborates with senior team members to process new client implementations and independently manages routine maintenance cases, ensuring compliance with enterprise standards and client expectations.

What You'll Do

* Uses extensive knowledge of reimbursement methodologies to analyze, define, and maintain hospital payer contracts including Medicare, Medicaid, Workers Compensation, and Commercial Payers using Health's Contract Manager software.

* Analyze and interpret complex contract provisions and reimbursement rates submitted by clients to identify all necessary terms for accurate system configuration.

* Research payer websites and regulatory sources (CMS, state Medicaid, commercial payers) to stay current on adjudication rules and reimbursement policies.

* Validate (and troubleshoot) system-generated valuations against client-submitted claims and estimates, reconciling discrepancies due to data entry errors or policy interpretation.

* Ensure contract terms are accurate and implemented in alignment with client intent and payer agreements.

* Respond to valuation-related support cases within defined Service Level Agreement timeframes.

* Participate in internal and client meetings to support project alignment and issue resolution.

* Contribute to process improvement initiatives aimed at reducing manual effort and enhancing data accuracy.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Need

* High School diploma or G.E.D. required.

* Bachelor's degree in Healthcare Administration, Finance, Accounting, or Business Administration preferred.

* Experience and Skills

* Minimum of 4 years' experience in the hospital industry, with direct involvement in payer contracts, facility reimbursement methodologies, and adjudication rules.

* Familiarity with hospital billing, claims management, and payer contracting.

* In depth knowledge of facility reimbursement models used by commercial payers, Medicare, and Medicaid for both inpatient and outpatient services.

* Proficiency in coding systems including CPT, HCPCS, DRG, Revenue Codes, Occurrence Codes, ICD-10 Diagnosis and Procedure Codes.

* Strong analytical, deductive reasoning, and problem-solving skills.

* Ability to adapt and learn new and changing reimbursement methodologies and underlying logic in a fast-paced environment.

* Excellent communication and customer service abilities.

* Advanced proficiency in Microsoft Office, especially Excel.

* Ability to work independently under tight deadlines in a fast-paced environment.

* Demonstrated commitment to accuracy, timeliness, and continuous learning.

Location & Compensation

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote- US

Compensation Range: $48,000-$72,000

Who We Are

Since 1999, UST has worked side by side with the world's best companies to make a powerful impact through transformation. Headquartered in the United States, UST is powered by technology, driven by AI, inspired by people, and led by our purpose, we partner with our clients from design to operation. Our AI-driven digital solutions, proprietary platforms, engineering, R&D, products, and innovation ecosystem turn core challenges into impactful, disruptive business outcomes. With deep industry knowledge and a future-ready mindset, we infuse expertise, innovation, and agility into our clients' organizations-delivering measurable value and positive lasting change for them, their customers, and communities around the world. Together, with 30,000 employees in 30 countries, we build for boundless impact-touching billions of lives in the process. Visit us at .

Benefits

Full-time, regular employees accrue a minimum of 10 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave and jury duty. They are eligible to participate in the Company's 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid Employee Only benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses as allowable under IRS guidelines. Benefits offerings vary in Puerto Rico.

Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company's 401(k) Retirement Plan with employer matching.

Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company's 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

Equal Employment Opportunity Statement

UST is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and "fair chance" ordinances.

UST reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

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CPT, HCPCS, Process Improvement, Claims Management