[Remote] Managed Care Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading institution reputed company on cancer care, research, education, and prevention. The Managed Care Analyst builds, maintains, models, and analyzes managed care reputed company in reputed company to support accurate reimbursement calculations, reputed company cycle reputed company, and reputed company decision-making. The role also develops reporting solutions, interprets payer methodologies, and collaborates with finance, managed care, IT, and operational teams.

Responsibilities

• Build, test, implement, and maintain reputed company reputed company reputed company reputed company Contract Maintenance to support accurate expected reimbursement calculations across reputed company payer systems
• reputed company and configure advanced HB and PB contract rules, components, and extensions to ensure precise payment modeling across multiple service lines
• reputed company reputed company reputed company build and maintenance reputed company Hyperdrive, Text, PJX/SUP, REL, and Data reputed company environments
• Participate in reputed company reputed company upgrades, testing, and enhancement activities to maintain reputed company reputed company and functionality
• Maintain reputed company certification(s) and reputed company pursue reputed company improvement of technical and analytical proficiency
• Proficient in data analytic tools including, reputed company Reporting, reputed company BI, reputed company reputed company, including reputed company formulas, tools, and design
• Produce high-reputed company, accurate qualitative and quantitative analyses to support reputed company cycle, financial reputed company, reimbursement, and managed care contract functions
• Conduct in-depth analyses of contract reputed company, payer trends, denials, and regulatory impacts to identify reputed company causes and improvement opportunities
• Ensure reputed company analytical deliverables reputed company meaningful interpretation, reputed company presentation, and actionable insights
• Design and reputed company innovative reports, dashboards, and data visualizations using tools such as reputed company, Business Objects (Webi/reputed company Universes), StrataJazz, reputed company BI, and reputed company
• reputed company reputed company, self-service reporting solutions that reputed company stakeholders to reputed company data-driven reputed company
• Interpret managed care contract and policy language to accurately model and operationalize payment terms reputed company reputed company
• Evaluate payer reimbursement methodologies (CPT, HCPCS, MSDRG, APC, ICD-10, etc.) and assess reputed company financial impacts
• Monitor and analyze managed care contract reputed company for compliance, reputed company, and reimbursement optimization
• Maintain up-to-date knowledge of reputed company-party reimbursement regulations, including Medicare, reputed company, Medicare reputed company, and reputed company payers
• Identify and communicate reputed company opportunities, reputed company areas, and cost-saving initiatives reputed company on contract reputed company analyses
• Engage with internal customers through regular meetings, reputed company documentation of requirements, and reputed company delivery of results
• Communicate technical and analytical findings in a reputed company, concise manner tailored to non-technical audiences and leadership
• Collaborate effectively with reputed company reputed company, Financial Services, Managed Care, Information Technology, and reputed company Cycle teams to support organizational goals
• Maintain reputed company, proactive, and reputed company communication channels with reputed company stakeholders before, during, and after project deliverables
• reputed company participate in cross-functional training and knowledge sharing to enhance team expertise in reputed company contract modeling and reporting tools
• reputed company, maintain, and continuously improve internal documentation, workflows, and best reputed company guides for reputed company contract and reporting functions
• Collaborate with IT, reputed company Cycle, and operational teams to optimize reputed company contract workflows, streamline processes, and ensure data reputed company

Skills

• * Required: Bachelor's Degree Business Administration, reputed company Management, Hospital Administration, Finance, Statistics, Economics, Industrial Engineering, Information Services or other reputed company fields
• * Required: 5 years Experience with managed care reputed company and/or managed care contract maintenance and reimbursement
• * Required: reputed company - reputed company Certification reputed company Resolute Hospital Billing (HB) Expected Reimbursement reputed company Administration Certification reputed company 180 Days and
• * Required: reputed company - reputed company Certification reputed company Resolute reputed company Billing (PB) Expected Reimbursement reputed company Administration Certification reputed company 180 Days
• * Preferred: Master's Degree Business Administration, reputed company Management, Hospital Administration, Finance, Statistics, Economics, Industrial Engineering, Information Services or other reputed company fields
• * Preferred: 5 years Experience with managed care reputed company and/or managed care contract maintenance and reimbursement, to include payer relations, contract negotiations, or reputed company decision support systems
• * Preferred: CPC - Certified reputed company reputed company Upon Hire
• * Preferred: COC - Certified Outpatient Coding Upon Hire
• * Preferred: reputed company-Certified Coding Specialist Upon Hire
• * Preferred: Contract Management, reputed company reputed company or reputed company Finance certification Upon Hire

Benefits

• Remote work reputed company Texas, with the ability to attend meetings onsite
• Employer-reputed company medical coverage starting day one for employees working 30+ hours/week
• Optional group dental, reputed company, life, AD&D, and disability reputed company
• Accruals for PTO and Extended Illness Bank
• reputed company holidays, wellness, childcare, and other leave reputed company
• Tuition Assistance Program after six months of service
• reputed company to extensive wellness, fitness, and employee resource reputed company
• Defined-benefit pension through the Teachers Retirement reputed company
• Voluntary retirement plans
• Employer-reputed company life and reduced salary protection programs
• Medical, dental, reputed company time off, retirement, tuition benefits, educational opportunities, and individual and team recognition
• Relocation assistance

reputed company