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    Managed Care Contract Analyst - Dallas, United States - Children's Health

    Children's Health
    Children's Health Dallas, United States

    3 days ago

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    Description

    Managed Care Contract Analyst-Managed Care

    Dallas, Texas |

    As a Managed Care Contract Analyst in the Managed Care department at Children's Health, you'll contribute to making life better for children by running data analysis, financial interpretation of contract terms, contract modeling, financial analysis, data validation, developing reimbursement methodologies, maintaining contracts in EPIC and identification of revenue enhancing opportunities. You will be responsible for developing alternative financial proposals that are within the budget parameters, based on analysis and modeling of contract performance by developing and preparing revised models using sound rationale, and presenting recommendations to Managed Care leadership. You will support the organization by providing ad-hoc detailed data reports related to Managed Care agreements and Patient Financial Services activity to internal and external costumers.

    This role will also include:

    · Completing financial impact analysis of contract negotiations, including modeling of contract proposals, reporting of contract proposal impact, performance and quantifying financial impact of these proposals for future year(s) and developing alternative proposals within the budget parameters. Presenting analysis and recommendations to leadership.

    · Preparing multiple analyses and presentations by extracting data from systems including Crystal, EPIC, STRATA and other Children's Health Services of Texas (CHST) systems and relational databases utilizing expertise in Excel. Evaluate the need to create new or modify existing ad hoc and/or customized reports work in partnership with project team leader to develop specific SMART (Specific, Measurable, Achievable, Relevant, Timebound) aims and metrics.

    · Interpret managed care contract terms and validates understanding with the contract negotiator and model relevant parameters into contract model application for contracts with annual revenue in excess of $1.5 Billion. Review all Managed Care contracts and amendments as received to ensure that all contracts in EPIC are current and calculating correctly.

    · Analyze contracts and prepare all supporting schedules necessary to update/maintain the EPIC system on a current basis. This includes but not limited to: reviewing all new contracts/amendments, meeting with Patient Financial Services staff to review changes, communicating with the payors to receive all updates on current basis, researching and downloading data form payor sites, analyzing and comparing new fee schedules to the prior fee schedules, preparing all uploads, validating input and updating EPIC reimbursement contracts.

    This is a remote position working Monday through Friday from 8:00 a.m. to 5:00 p.m. It is required to come into the office at a minimum of 3 times a month.

    Experience

    Required: At least 3 years of experience in financial analysis, data mining and reporting required. At least 3 years of experience in healthcare, contract modeling for facility and professional agreements is also required.

    Preferred: At least 3 years of experience with hospital billing system, EPIC

    Education

    Required: Four-year Bachelor's degree or equivalent experience required.

    Licenses and Certification's

    Required: EPIC certification within one year of hire

    About us

    Children's Health values the role each member of our team plays in making life better for children. We employ more than 7,500 people and provide rewarding career opportunities that help you reach your highest potential.

    We are widely recognized for delivering high quality care, we serve as the primary pediatric teaching facility for the University of Texas Southwestern Medical Center, and we have been named one of the 150 Top Places to Work in Healthcare by Becker's Healthcare for nine consecutive years.

    Learn more about Children's Health.

    Benefits

    Children's Health offers competitive pay, a comprehensive benefits program and opportunities for learning and career development. We promote a diverse and inclusive workplace, and our team members have a voice in their work through surveys and town halls.

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