Contract Analyst

JOHN J. WARE

*** **** ******** *** ****, AZ 480-***-**** **********@*****.*** linkedin.com/in/john-ware-987a41b

CONTRACT ANALYST - HEALTHCARE

Dedicated healthcare professional with extensive analytical skills and expertise in provider network management. Proficient in claims adjudication, healthcare regulations and compliance. Demonstrated success using Excel to optimize healthcare contracts. Core Skills include:

Contract Negotiation and Management Provider Network Development and Management

Claims Adjudication Healthcare Regulations and Compliance Data Analysis and Reporting

Problem-solving and Critical thinking Written and Verbal Communication Detail Orientation

PROFESSIONAL EXPERIENCE

CVS/Aetna, Inc., Scottsdale, AZ November 2013 - August 2023

Provider Systems Data Administrator

Collaborated with leadership directors and network teams to review, verify, and build provider rates for performance testing.

Conducted in-depth analysis of contract terms and conditions to ensure compliance with regulatory requirements and organizational standards.

Utilized Excel to import and maintain contract databases, tracking critical dates, fee schedules, lookup tables and minimal TAT.

Conducted corrective actions to discrepancies identified by regular audits assuring claims payments were processed correctly.

Played a key role in the training of team members in the linking of all ancillary records and providers to proprietary web database.

Consistently maintained an overall performance rating metric of 99%.

Coventry Healthcare, Inc., Scottsdale, AZ November 2011 – November 2013

Client Services Representative

Assisted clients, patients, and providers with locating medical status and network participation.

Responded to client and patient requests for listings of doctors, hospitals, urgent care facilities.

Assured protection of client and patent information in accordance with HIPAA standards.

Provided exceptional client support experience

MILITARY EXPERIENCE

Air Force Satellite Communications Controller – U.S. Air Force

Monitored and controlled polar/equatorial communications space craft worldwide.

Trained newly assigned personnel on fundamental satellite operations that support air taskings

Completed training certifications and formal attended Air Force Satellite Communication training.

EDUCATION

Bachelor of Science in Information Systems, University of Phoenix

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