Managed Care Analyst jobs in the United States

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Managed Care Data Analyst
  • Sarasota Memorial Health Care System
  • Sarasota, FL FULL_TIME
  • Job Description

    Department

    Managed Care

    Job Summary

    Works with Managed Care Analyst Sr to oversee the balancing, reconciling, and resolution of errors for the daily 835 and 837 files, charges, payments, adjustments and contractuals to the patient accounts receivable system. Provides training, guidance, and support with the use of the managed care contracting system by Patient Financial Services (PFS) and other Revenue Cycle team members through education and daily communication. Oversees the Master Tables as assigned and collaborates with the Managed Care team to implement process improvements. Provides guidance and support for other system maintenance functions as required for data integrity of the contract modeling software. Develops reports/report views and explains and interprets data as requested and maintains report libraries. Collaborates with Managed Care Analyst Sr in modeling proposed contracts and loading finalized contracts. Oversees all contract naming conventions, organization of payor models, organization of scanned and paper contracts, rate schedules, payor correspondence, and the managed care smh.com website. Performs other duties as assigned in support of the Managed Care Department.

    Required Qualifications

    • Require a bachelor’s degree in a relevant field of study.
    • Require experience in at least two (2) of the following: Microsoft Excel data analysis, Microsoft PowerPivot / SSAS, Power BI, SQL Server (coding or database maintenance), SSRS, RStudio, Python, PowerShell, or other similar analytics toolset or programming language.

    Preferred Qualifications

    • Prefer experience in a managed care setting.
    • Prefer knowledge of health insurance plans and managed care contracts.
    • Prefer proficient excel user with experience using complex formulas and pivot tables.
    • Prefer previous experience in generating a variety of reports.
    • Prefer coding certificate (i.e. CPC) or CPAT/CRCS.
    • Prefer demonstrated knowledge of hospital billing, including hospital charges, CPT, DRG, APC, APRDRG, revenue codes, and ASC Groupers
    • Prefer demonstrated knowledge of contract modeling software, contract terms, and contract modeling.
    • Prefer demonstrated ability to relate to a wide variety of people using excellent written and verbal communication skills.
    • Prefer demonstrated organizational, analytical, leadership and judgment skills.
    • Prefer demonstrated proficiency with Windows-based office applications including Excel, Word, PowerPoint, Access, and Outlook.
    • Prefer knowledge and experience with hospital and physician billing, payer claims adjudication and analyzing payment patterns.

    Preferred Education

    M D: Masters Degree
  • 1 Day Ago

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Managed Care Analyst / Managed Care / Full-Time
  • Catawba Valley Health System
  • Claremont, NC FULL_TIME
  • SummaryJob DescriptionPosition is responsible for working with various internal and external customers regarding contract payor terms, policy/procedure updates, payor administration, variances/contrac...
  • Just Posted

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Managed Care Analyst / Managed Care / Full-Time
  • Catawba
  • Claremont, NC FULL_TIME
  • Summary: Position is responsible for working with various internal and external customers regarding contract payor terms, policy/procedure updates, payor administration, variances/contract modificatio...
  • 12 Days Ago

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Managed Care Analyst III
  • Teva Pharmaceuticals
  • Parsippany, NJ FULL_TIME
  • Apply now » Managed Care Analyst III Date: May 3, 2024 Location: Parsippany, United States, New Jersey, 00000 Company: Teva Pharmaceuticals Job Id: 55746 Who we are Together, we’re on a mission to mak...
  • 17 Days Ago

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Managed Care Operations Analyst
  • Cooper University Hospital
  • Camden, NJ OTHER
  • About Us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations...
  • 17 Days Ago

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Managed Care Analyst
  • Teva Pharmaceuticals
  • Parsippany, NJ FULL_TIME
  • Apply now » Managed Care Analyst Date: May 21, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 56101 Who we are Together, we’re on a mission to make g...
  • Just Posted

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Senior Commercial Manager
  • gategroup
  • Reston, VA
  • About us Gate Gourmet, a gategroup company, is the world's largest independent provider of catering and provisioning ser...
  • 5/26/2024 12:00:00 AM

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Behavior Specialist
  • CRi
  • Chantilly, VA
  • Description Real Heroes Work Here! CRi is a well-known non-profit organization located throughout Northern VA, Richmond ...
  • 5/25/2024 12:00:00 AM

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Software Developer
  • CGI Group, Inc.
  • Chantilly, VA
  • Software Developer Position Description CGI is seeking a Software Developer to support a large a federal agency. The Sof...
  • 5/25/2024 12:00:00 AM

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Consultant
  • AArete
  • Vienna, VA
  • Description Consultant AArete is one-of-a-kind when it comes to consulting firm culture. Why AArete? We are a global, in...
  • 5/25/2024 12:00:00 AM

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Litigation Systems Analyst
  • CONTACT GOVERNMENT SERVICES
  • Vienna, VA
  • Litigation Systems Analyst Employment Type: Full Time, Mid-level Department: Litigation Support CGS is seeking a Systems...
  • 5/24/2024 12:00:00 AM

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Senior Human Resources Information System Analyst
  • gategroup
  • Reston, VA
  • About us Gate Gourmet, a gategroup company, is the world's largest independent provider of catering and provisioning ser...
  • 5/23/2024 12:00:00 AM

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Service Desk Technician (Business, clearance Sponsorship)
  • CACI International
  • Chantilly, VA
  • Service Desk Technician (Business, clearance Sponsorship) Job Category: Information Technology Time Type: Full time Mini...
  • 5/22/2024 12:00:00 AM

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Network Security Analyst III
  • Battelle Memorial Institute
  • Chantilly, VA
  • Battelle delivers when others cant. We conduct research and development, manage national laboratories, design and manufa...
  • 5/22/2024 12:00:00 AM

Income Estimation for Managed Care Analyst jobs
$61,142 to $95,915