Job Summary :
This position must be filled by a person who possesses and consistently demonstrates the highest level of personal integrity and professional judgment, and who is able to work in a collaborative collegial and respectful manner in a fast paced environment. The Managed Care Analyst must provide support for Managed Care Department through data analysis, complex modeling, organizing the Managed Care database, and communicates findings in a meaningful manner while supporting the negotiation process. The person must have the ability to change priorities and readily adapt to change.
Minimum Qualifications (Experience, Education and Special Certifications…)
- Query data bases and abstract large quantities of data to present in a clear concise summary
- Analyzes data and information from contracts and presents results to department leadership for resolution of complex contracting issues.
- Create complex models of hospital contract reimbursement
- Develop power point presentations
- Organize and maintain Managed Care database
- Monthly reporting of results, report Managed Care yield
- Update Hospital Business Offices of contract terms and provide decision support of contract terms
- Review and abstract contracts
- Communicates with hospital leadership on contract issues
- Works with department leadership to improve contracting processes
- Assist in negotiation of agreements
- Negotiate low level contracts over time
- Highly organized
- Candidate will have a bachelor’s degree in accounting, finance or economics. MBA required.
- 2-3 years of data reporting or data warehousing
- Highly proficient in Excel and use of query tools, including SQL and Business Objects
- Knowledge and application of statistical analysis preferred
- This role will use computers, extensively, with heavy emphasis on Excel
- Must possess excellent communication skills at all levels, both verbally, and in writing, with the ability to tailor the message to individuals across the organization
- Ability to think strategically, and will be self motivated, able to meet deadlines, and will respond well to time constraints and pressure
- Must be able to work independently, as well as have a working knowledge of HCPCS, Hospital Revenue Codes, and Commercial and Governmental Hospital Reimbursement
- Experience with data analysis in the Hospital industry
- Ability to review large amounts of data and present findings in a concise manner.
- Good communication skills
This job description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this job description. The individual(s) may be called upon and required to follow or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives.