Provider Contract Analyst (Healthcare)

TL;DR

Provider Contract Analyst (Healthcare): Managing post-acute care contracting for home health, hospice, and skilled nursing facilities with an accent on the contract lifecycle and financial reimbursement. Focus on negotiating agreements, ensuring contractual compliance, and resolving payment issues between providers and the organization.

Location: Remote (Preference for candidates based in Western Pennsylvania, USA)

Company

hirify.global is a large integrated healthcare organization providing health insurance and care delivery services.

What you will do

• Manage the end-to-end contract lifecycle, including negotiations, development, and renewals for post-acute care providers.
• Monitor contract terms and conduct audits or site visits to ensure strict adherence to compliance standards.
• Analyze claims and medical record data to optimize care services and recover inappropriate payments.
• Serve as the primary liaison between the organization and external entities to resolve contractual and payment disputes.
• Facilitate final provider settlements and establish structured collection protocols.
• Collaborate with the Medical Director and customer service to address billing appropriateness and medical necessity.

Requirements

• Associates degree in Business, Finance, Healthcare Administration, or a related field.
• 5 years of experience in healthcare administration, delivery, or finance.
• Strong understanding of healthcare finance and regional market environments.
• Proficiency in Microsoft Word, Excel, and PowerPoint.
• Experience with medical terminology and coding.
• Must be authorized to work in the US.

Nice to have

• Bachelor's degree in a relevant discipline.
• MBA or CPA certification.

Culture & Benefits

• Remote-based work arrangement.
• Commitment to high ethical and legal standards, including HIPAA compliance.
• Support for continued educational coursework related to the position.
• Professional environment with focus on teamwork and organizational efficiency.