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
  • 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

  • 2 Days Ago

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Medical Assistant for a Managed Care Clinic
  • EVOLVE MANAGED CARE SOLUTIONS
  • Augusta, GA FULL_TIME
  • Medical Assistant- Managed Care/ Case Management · One (1) year related experience.· CMA certified · Strong interpersonal skills with patients and co-workers.· Proven ability to interact professionall...
  • 1 Day Ago

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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...
  • 11 Days Ago

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Contract Analyst, Managed Care
  • Mercyhealth
  • Janesville, WI FULL_TIME
  • Overview Managed Care Contract Analyst, Days, 80 Hrs / 2 wks Location: Mercycare Bldg, Janesville, WI OR Rockton Ave Campus, Rockford, IL. Hybrid, flexible work schedule, and remote opportunities avai...
  • 22 Days Ago

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Managed Care Financial Analyst
  • Mountain State Oral and Facial Surgery
  • Huntington, WV FULL_TIME
  • Cabell Huntington Hospital is seeking a full-time Managed Care Financial Analyst to work alongside our Contract Management Department. The Managed Care Financial Analyst is responsible for ensuring ac...
  • Just Posted

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Managed Care Financial Analyst
  • Wroblewski & Newsom, PLLC
  • Huntington, WV FULL_TIME
  • Cabell Huntington Hospital is seeking a full-time Managed Care Financial Analyst to work alongside our Contract Management Department. The Managed Care Financial Analyst is responsible for ensuring ac...
  • 2 Days Ago

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Lead Cyber Security Analyst (Remote)
  • CareFirst
  • Reston, VA
  • Resp & Qualifications PURPOSE: To ensure the organization's data remains protected from inappropriate access, disclosure...
  • 3/28/2024 12:00:00 AM

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Sales Account Executive
  • Centric Business Systems
  • Mc Lean, VA
  • Purpose The primary responsibility for this position is selling business technology solutions through prospecting and co...
  • 3/28/2024 12:00:00 AM

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Buyer, Day Shift, Material Management
  • Adventist HealthCare
  • Gaithersburg, MD
  • Support Center If you are a current Adventist HealthCare employee, please click this link to apply through your Workday ...
  • 3/28/2024 12:00:00 AM

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Senior Associate, Product Manager - Retail Bank
  • Capital One
  • Mc Lean, VA
  • 1750 Tysons (12023), United States of America, McLean, Virginia Senior Associate, Product Manager - Retail Bank At Capit...
  • 3/27/2024 12:00:00 AM

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Facilitator, Mid-Level, Federal Contracting
  • IMSolutions, LLC
  • Gaithersburg, MD
  • IMSolutions seeks a strategic and experienced Mid-Level Facilitator to fill an exciting opportunity working in federal g...
  • 3/27/2024 12:00:00 AM

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Facilitator - Senior Level, Federal Contracting
  • IMSolutions, LLC
  • Gaithersburg, MD
  • IMSolutions seeks a strategic and experienced Senior Facilitator to fill an exciting opportunity working in federal gove...
  • 3/27/2024 12:00:00 AM

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Research Analyst II
  • ENSCO, Inc.
  • Fairfax, VA
  • Job Description Formulate and apply mathematical modeling and other optimizing methods to develop and interpret informat...
  • 3/24/2024 12:00:00 AM

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Senior Research Analyst
  • ENSCO, Inc.
  • Fairfax, VA
  • Job Description Formulate and apply mathematical modeling and other optimizing methods to develop and interpret informat...
  • 3/24/2024 12:00:00 AM

Income Estimation for Managed Care Analyst jobs
$60,630 to $95,138