Network Prov Contract Implem Anl Assoc
Company: Blue Cross and Blue Shield Association
Location: Saint Paul
Posted on: November 24, 2022
About Blue Cross
Blue Cross and Blue Shield of Minnesota is one of the most
recognized and trusted health care brands in the world with 2.9
million members. We're committed to reinventing health care to
improve health for our members and the community. We hope you'll
How Is This Role Important to Our Work?
This position coordinates aspects of standard and non-standard
provider contracts for lines of business and provider networks
including managed care, open access and point of service delivery
systems. This position implements provider data per contractual
agreements and ensures that provider data payment information is
loaded into the appropriate claim payment agreements and tables in
the source provider system that directs payment transaction
processing. This position is also responsible for assisting,
collecting and analyzing data, supports more senior level positions
in carrying out projects. Provides documentation for projects. This
position receives assistance/ direction from either management or
principal(s) on the team.
A Day in the Life:
* Perform analysis, build, and maintain multiple tables in the
Reimbursement system including claim payment tables and claim
* Set up and maintain provider networks, and perform network
validation/testing, as needed.
* Serve as a knowledge expert around the setup and maintenance of
provider network Information.
* Research and refine existing assumptions and procedures to
present recommendation for change.
* Participate in design, development and maintenance of contracting
* Research and responds to internal and external inquiries.
* Identify workflow and system changes that will enhance the
management of provider data.
* Prepare reports and assist in research and analysis of data.
* Perform audits of the provider data to ensure data quality and
* This position assists senior positions in collecting and
analyzing data to support department workload and special projects,
performing experience analyses or developing assumptions.
* Documents methods, procedures and results.
* Works with senior positions or management to understand and
interpret the data to support projects and/or relevant data.
* This position receives assistance/ direction from either
management, principal(s) or senior(s) on the team.
* And is able to work on multiple priorities, deadlines and has the
ability to adapt to change.
Required Skills and Experiences:
* Bachelors degree in Business, Accounting, Finance, Economics or
related field and 2 years provider related or analytical
experience, or a minimum of 6 years of provider related experience
in lieu of a degree.
* Microsoft Word and Excel experience.
* Proven ability to work in a team environment, assisting
co-workers and achieving team goals.
* Excellent organizational skills with the ability to
* Demonstrated knowledge of provider reimbursement and payment
* Demonstrated analytical and problem solving skills.
* Proven ability to manage multiple projects.
* Excellent verbal and written communications skills.
Role designation definition: Teleworking is working full time
remote. Hybrid is a combination of working onsite and remotely.
Onsite is full-time onsite.
Make a difference
Blue Cross is an Equal Opportunity and Affirmative Action employer
that values diversity. All qualified applicants will receive
consideration for employment without regard to, and will not be
discriminated against based on race, color, creed, religion, sex,
national origin, genetic information, marital status, status with
regard to public assistance, disability, age, veteran status,
sexual orientation, gender identity, gender expression, or any
other legally protected characteristic.
Reasonable Accommodation for Job Seekers with a Disability: If you
require reasonable accommodation in completing this application,
interviewing, completing any pre-employment testing, or otherwise
participating in the employee selection process, please direct your
inquiries to email@example.com.
All roles require a high school diploma (or equivalency) and legal
authorization to work in the U.S.
Blue Cross - and Blue Shield - of Minnesota and Blue Plus - are
nonprofit independent licensees of the Blue Cross and Blue Shield
Keywords: Blue Cross and Blue Shield Association, St. Paul , Network Prov Contract Implem Anl Assoc, Other , Saint Paul, Minnesota
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