Managed Care Analyst
Good Samaritan Hospital Medical Center - West Islip, NY

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Make a great choice with a career at Good Samaritan!
Good Samaritan recognizes that the high quality care it delivers every day is enhanced by supporting the career goals of its staff. Whether this includes extending our expertise in dealing with complex medical conditions, keeping up with the latest technology or advancing your education, Good Samaritan actively promotes these objectives. Along with a competitive salary and comprehensive benefits in a collegial atmosphere, you'll also enjoy the rewards and lifestyle of a community unlike any other.
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Managed Care Analyst
Working in collaboration with physicians, hospital departments and managed care organizations, the analyst will resolve issues that impede the provision of timely, high quality care for managed care clients. Responsible for educating and assisting hospital departments in meeting internal and MCO operational requirements. Assists in the negotiation of hospital based physician managed care agreements and informs departments of contract terms. Facilitates the required data and information exchanges between Managed Care, Case Management and Patient Accounts related to the new contract terms, rates and appeals process. Analyzes data for payer negotiations and validates payer volume for managed care models. Works with Patient Accounts to identify and resolve issues related to timely payment of managed care claims and maintains Managed Care rate grid, contractual term matrix, and Managed Care Plan Appeals Process matrix. Responsible for the generation of reports to Patient Accounts, HIM, Patient Care Services and other departments as requested. In addition, the analyst will serve as a liaison for Patient Accounts, Quality Management, Utilization Management, Admitting, Emergency Room, HIM and other hospital departments as necessary regarding the day-to-day management of current managed care relationships. Performs other duties as assigned.
Associate degree required. Bachelor's degree preferred. Minimum of 2 years health care experience required, preferably in managed care or financial arena.

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