Senior Managed Care Contract and Data Analyst
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Job Description
Collaborate with VP of Managed Care to manage contract databases and financial analysis for joint venture hospital partners. Support revenue cycle and ensure compliance with federal regulations.
Responsibilities:
- Serve as the managed care liaison and subject matter expert for joint venture hospital partners, revenue cycle billing and collections teams, and finance department leaders.
- Compile and analyze payer performance metrics for reporting to organizational leadership.
- Maintains up-to-date managed care contract databases to streamline collections, support analysis, and share contract terms efficiently.
- Assist the revenue cycle team by loading and maintaining current payer rates in an insured allowed/payment validation module.
- Perform random audits of claim payments to ensure payer compliance with managed care agreements.
- Support special projects, including claim data analysis for contract negotiations, service line research, and pro formas for new market opportunities.
- Build contract models to assess current performance yields and evaluate new contract proposals.
- Collaborate with the revenue cycle team to identify underpaid/overpaid claims and develop initiatives to secure accurate payments.
- Provide managed care insights and contract modeling (e.g., rate escalators, charge master updates, new contract yields) to support the finance team’s annual budget process.
- Aid the revenue recognition team during month-end close by offering managed care perspectives on key revenue-influencing items.
- Ensure compliance with federal and state price transparency regulations by preparing and maintaining required files.
- Represent managed care in joint venture board meetings or monthly operational reviews as required.
- Conduct financial data analysis and respond to internal/external inquiries from management.
Requirements:
- Bachelor’s degree in Finance, Accounting, Business Administration, or equivalent experience required.
- Minimum of 3 years of healthcare experience preferred, with deep knowledge of hospital payment methodologies and health plan contracting processes.
- Proven ability to build financial and statistical models, analyze data, and drive actionable results.
- Excellent organizational, written, and verbal communication skills.
- Advanced Microsoft Excel modeling skills (required); proficiency in Word, PowerPoint, and Outlook (essential).
- Ability to write efficient queries for data retrieval, filtering, and manipulation using SQL
- Intermediate knowledge of data preparation and visualization techniques using PowerBI
- Strong analytical and problem-solving capabilities.
- Comfortable working in a fast-paced environment with minimal supervision.
- Ability to meet deadlines while managing multiple projects and delivering high-quality work.
- Detail-oriented with a strategic, big-picture mindset.
Benefits:
- Employee Pricing Transparency
- Remote work options
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