CardioNet Strategic Contracting Operations Analyst in Malvern, Pennsylvania

OVERVIEW: Responsible for activities associated with the operations, implementation and maintenance of executed contracts for third party programs. Works cross-functionally (e.g. Sales, Marketing, Reimbursement, Information Technology, Accounting, Finance and Legal) to coordinate contract administration for medical benefit programs including processing, billing, reimbursement, and payment information. Ensures that policies and procedures are revised and implemented to address any operational issues that are identified on the BioTelemetry Healthcare side. Knowledge and understanding of products and services, operations and contracts as well as knowledge of the managed care and insurance industries and their respective business issues and potential opportunities. Develops policies and procedures and manages processes related to pricing and contract requests from Sales. RESPONSIBILITIES: Responsible for the Service Level Adherence process which entails ongoing tracking of performance and adherence to contractual commitments. Prepares adherence reports and trend analysis and issues early warning alerts on potential deficiencies. Administers the Quarterly and Annual Service Level Reviews and Strategy meetings to collectively gauge our performance against contractual commitments. Monitors volume reports and builds analytical analysis reports that project volumes over the course of the month, quarter and Fiscal year against the Planned volumes. Monitors the contract terms and commitments to assure all deliverables are adhered to and take proactive measures before key milestones are missed. Monitors the implementation process for all third party programs, while balancing client needs and company objectives to ensure a successful/positive implementation for both parties. Ensures maximum gross referrals and profit by working closely with Strategic Contracting through the ongoing review and confirmation of any non-standard third party plan setup requests. Works with corporate and field on any reimbursement issues, and brings exceptions or non-standard requests to the attention of senior management where appropriate. Maintains communication regarding third party participation, contract compliance, and any other operational issues or opportunities. Responsible for the tracking, approval, administration, and post-implementation process of all Managed Care contracts throughout the contract life cycle. Works with Strategic Contracting to review contracts to ensure operational requirements can be met and implemented. Monitors the technical links between the Third Party Provider and data tracking systems to assure reported issues are properly captured, reported, prioritized and managed to closure. Oversees a Third Party Governance Process including periodic status calls, quarterly performance reviews, annual business planning, change order reviews and Third Party budgets/ costs. Conducts periodic meetings/ calls with internal departments to address administration issues, and coordinates resolution with the Service Provider as required. Constructs and maintains our financial and billing reports on a comprehensive database and adapts the content and analytical capabilities to adapt to our continuously changing business needs, working with Reimbursement and Finance as appropriate. Trains and provides ongoing education to personnel, customers, contractors, etc. on processes and procedures to address Payor related issues, updates, and opportunities Works with appropriate internal and external part