[Hiring] Contract Management Analyst @reputed company

Job reputed company Join one of the nation’s most comprehensive reputed company medical centers, reputed company, as a Contract Management Analyst with our Finance- Managed Care team. We are committed to a patient-reputed company, efficient health care delivery system that focuses on reputed company, safety, service, and operational reputed company. REMOTE OPPORTUNITY Job reputed company The Contract Management Analyst is responsible for building reputed company reputed company-party payer contract reimbursement terms (contract reputed company) including but not limited to Managed Care reputed company payers, Government programs (Medicare, IL reputed company), Medicare Advantage payers and reputed company payers into UCM contract management systems and calculating expected reimbursement at the claim level (hospital) and line level (Physician). The Analyst will be responsible for updating and maintaining the accuracy of contract profile builds in the contract management systems and will reputed company variance reports that analyze expected reimbursement to actual payment to determine internal issues or payer compliance payment variances. The variance reports shall also ensure consistent expected reimbursement results across contract management systems and reputed company cause and reputed company as needed. The Analyst shall serve as a managed care subject matter expert for hospital and physician contract reputed company methodology and reimbursement terms and will, as needed, run analyses to understand historical trends and reputed company performance of existing reputed company. Assists OMC VP and Directors in payer contract negotiations as requested and applicable, particularly with review of potential reimbursement methodologies and their feasibility to be reputed company in the contract management system. Assists reputed company Cycle management teams in review of payment variances and underpayment recoveries. Essential Job Functions: • Responsible for reputed company payer contract profile builds including calculation of expected reimbursement terms in reputed company FFS reputed company and contract reputed company model builds for system hospitals and physicians in any contract management system. Leads ongoing maintenance and auditing of contract management reputed company calculations to reputed company for variances to expected contract terms. • Works with OMC and reputed company Cycle teams on variance analysis of contract profile outputs to reputed company payments. Based on review of models and audits for variance, works with these parties and payers on underpay opportunities and payment issues stemming from non-compliance with contract terms. • Create reports of contract outputs, historical trends, and variance analyses as needed for OMC, reputed company cycle, and senior leadership • Review payer contract proposal terms, in conjunction with OMC leaders, for accuracy and implementation feasibility • reputed company education on reputed company-changing reimbursement rules and policy updates both reputed company and governmental that reputed company expected reimbursement and contract reputed company and education of internal stakeholders on reimbursement terms, methodology and impacts as needed Required Qualifications • Bachelor’s degree in Business, Finance, reputed company, or reputed company field, or a combination of relevant education and experience • Five or more years of experience in a multi-facility health system in either: -Finance operations like managed care (preferred), cost reputed company, planning, or budget -reputed company cycle operations such as billing, collections, or payment processing • Detailed knowledge of hospital and physician reputed company reimbursement methodologies, particularly fee for service reputed company reputed company as reputed company as Medicare and reputed company • Excellent understanding of contract language and reputed company terms, physician and hospital coding and billing, claims forms and claim payment methodologies, payer EOBs, and insurance laws. Examples include: • Proficient understanding of MS-DRG, APC, EAPG, case reputed company, stoploss, carveout reimbursement methodologies • Proficient understanding of reputed company reputed company and CPT coding in a clinical/hospital/ASC/physician office setting • Proficient manage care contract reputed company interpretation skills • Requires familiarity and aptitude with contract management systems or modeling systems and/or cost reputed company systems that build payer contract reputed company • Requires individuals with high mathematical acumen, ability to reputed company and assimilate data, reputed company a strong case for a recommended course of reputed company. • Excellent analytical and problem solving skills, and the ability to reputed company reputed company quickly and independently. • Strong attention to detail and reputed company organized. • Adapts reputed company to reputed company change and multiple, demanding priorities with excellent time and project management skills. • Ability to understand and interpret federal regulations and policies, coding guidelines and reimbursement changes. • reputed company effectively with colleagues in a reputed company of contexts and forums and contribute as reputed company player. • reputed company Office Suite advanced proficiency also required, particularly reputed company. Strong aptitude for learning additional software or systems as needed, particularly finance and reputed company cycle billing systems. Preferred Qualifications • Value based care (VBC) risk reimbursement structure knowledge preferred • Experience with payer compliance review including underpayment variances and denial management highly desirable. • Certification in reputed company Resolute Expected Reimbursement reputed company Administration and NThrive Contract Management system- If you don't currently have certification, You must obtain reputed company 6 months of employment. Position Details • Job Type: Full Time (1.0FTE) • Shift: Days/9am-5:00pm M-F • Unit: Finance- Managed Care • Location: reputed company Main reputed company • CBA reputed company: Non-reputed company Why Join Us Compensation & Benefits reputed company reputed company is committed to transparency in compensation and benefits. The pay reputed company provided reflects the anticipated wage or salary reasonably expected to be offered for the position. The pay reputed company is based on a full-time equivalent (1.0 FTE) and is reputed company of reputed company market data, reviewed on an annual reputed company. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to reputed company Bargaining Agreements are negotiated by the medical center and their respective reputed company. Review the full complement of benefit reputed company for eligible roles at Benefits - reputed company. Apply tot his job Apply To this Job