The Senior Contracts & Network Operations Analyst is responsible for leading the design, implementation, and maintenance of the organization’s healthcare contract management processes. This role serves as a strategic resource for interpreting complex contract terms, conducting reimbursement reviews, and facilitating collaboration across departments. The analyst ensures accuracy, compliance, and operational efficiency while fostering alignment between contracting, credentialing, and network enrollment teams.
Essential Duties and Responsibilities
Contract Process Design and Administration
· Design, implement, and maintain a centralized contract management repository and execution workflow that ensures visibility, compliance, and accessibility.
· Develop standardized procedures for contract routing, review, approvals, and archiving.
· Support automation and integration of contract data into operational and reporting systems.
· Monitor contract status, expirations, and renewals to ensure timely execution.
Contract Review and Redlining
· Review, redline, and summarize agreements to ensure consistency with organizational standards and payer requirements.
· Collaborate with operations and finance teams on rate and language strategy.
· Conduct 1st level review of Fair Market Value (FMV) reimbursements to ensure compliance and alignment with industry standards.
· Recommend improvements to recurring contract templates or standard language.
Cross-Departmental Support and Guidance
· Serve as a subject-matter resource for interpreting contract terms and payer relationships for internal partner teams.
· Provide guidance on contracting entities, reimbursement terms, credentialing requirements, and participation status.
· Work with IT and leadership to develop a ticketing system to log, assign, and resolve workflows for the department.
Credentialing and Network Enrollment Collaboration
· Partner with credentialing and network enrollment teams to utilize contract terms to streamline provider onboarding and participation approvals.
· Clarify payer-specific credentialing and participation requirements derived from contract language.
· Support resolution of enrollment or credentialing escalations requiring interpretation of payer or network agreements and / or finding an appropriate escalation path.
Process Improvement and Reporting
· Identify opportunities to improve efficiency and compliance within the contract lifecycle.
· Participate in cross-functional initiatives to enhance data integrity and visibility across departments.
· Assist in the development of dashboards, metrics, and reports to track contract activity and inquiry resolution.
Qualifications
Education
· Bachelor’s degree in Healthcare Administration, Business, Legal Studies, or a related field required.
· Equivalent combination of education and experience may be considered.
Experience
· 15+ years of experience in healthcare contract analysis or management.
· Deep understanding of healthcare reimbursement models, managed care, and regulatory frameworks.
· Familiarity with payer-provider dynamics and network contracting.
· Monitor contract performance and enforce service-level agreements (SLAs).
Skills and Competencies
· Proficiency in contract management software.
· Exceptional negotiation, analytical, and communication skills.
· Strong organizational skills with attention to detail
· Proficiency in contract review, redlining, and summarizing complex language for non-legal audiences.
· Excellent written and verbal communication abilities.
· Proficient in Microsoft Office (Word, Excel, PowerPoint) and CRM/ticketing tools (e.g., Jira, Zendesk, ServiceNow).
· Ability to manage multiple priorities and maintain confidentiality.
· Strong understanding of factors influencing contract relationships, including the impact of provider information changes and integration of new provider additions.
· Ability to form and maintain external and internal relationships