EPIC Contract Management Analyst

Job Summary:

The EPIC Contract Management Analyst analyzes changes to reimbursement rules and regulations for all payers, evaluates the impact on hospital and physician reimbursement, and educates appropriate personnel.

The EPIC Contract Management Analyst maintains Epic’s contract management module and content related to executed contracts and modeling, ensuring data integrity and consistency.

He/she provides analytical support for operational leaders as it relates to Managed Care contracts and payment issues.

The EPIC Contract Management Analyst is responsible for report requests from Revenue Cycle or other departments as it relates to Contract Management.

The EPIC Contract Management Analyst gathers and analyzes information collected from both internal and external sources to provide accurate, timely, appropriate, and value-driven information cost-effectively to support Managed Care Contracting and negotiations.

Duties and Responsibilities:

Design, build, analyze, test, and provide support for Epic’s Reimbursement Contracts. Load contract language and terms in Epic

Serve as a subject matter expert for Epic’s Reimbursement Contracts module.

Writes reports and studies to support and facilitate contract negotiations and Revenue Cycle operations.

Writes reports and studies to support and facilitate Chargemaster updates and changes.

Supports the development of adequate data collection and reporting to monitor the performance of third-party payor agreements.

Research and implement new contract language, payor policies, and any updated language as executed by payers and all parties.

Researches and interprets government payment rules and policies to ensure accurate Epic configuration

Assist with managed care financial analysis, modeling, and analyzing contract proposals.

Translate annual contract terms into build configuration in Epic

Configure contracts to reflect modifier percentage changes and re-evaluate existing contractual write-offs

Import fee schedules

Assist with contract negotiation processes as needed

Develops a thorough understanding of CNE third-party contracts and payment methodologies.

Develops methods to monitor contract compliance trends and performance.

Maintains professional growth and development to keep abreast of the latest trends in the field of expertise.

Preserves and protects patient and employee rights to confidentiality.

Performs other duties related to job responsibilities.

Requirements:

Bachelor’s degree in Business Administration, Information Systems, Health Care Administration, Finance, or a combination of work and education experience required.

Detailed knowledge of hospital contracts, billing, and claims processing is required.

The position also requires excellent analytical skills, advanced knowledge of spreadsheets and databases as well as working knowledge of personal computers, including word processing applications.

Epic Certification Preferred.

Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.

Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.