[Hiring] Managed Care Contract Analyst @Children's Health

Role Description

Primary responsibilities include supporting the administration, configuration, testing, validation, implementation, and maintenance of managed care reimbursement contracts within Epic Professional Billing (PB). The position supports assigned components of the Epic PB/HB contract lifecycle, including:

• Contract interpretation
• Build preparation
• Testing
• Reconciliation
• Maintenance
• Payer and plan mapping
• Issue resolution

Complex interpretation and configuration decisions are escalated to Senior Analysts and/or the Director. Analytics, reporting, and financial modeling are secondary responsibilities used to support:

• Epic configuration
• Reimbursement validation
• Contract performance monitoring
• Identification of underpayments and revenue opportunities

Responsibilities include:

• Data analysis
• Financial interpretation of contract terms
• Contract modeling
• Financial analysis
• Data validation
• Developing reimbursement methodologies
• Maintaining contracts reimbursement in EPIC
• Identification of revenue enhancing opportunities
• Developing alternative financial proposals within budget parameters
• Presenting recommendations to Managed Care leadership
• Providing ad-hoc detailed data reports related to Managed Care agreements and Patient Financial Services activity

Qualifications

• At least 3 years experience in financial analysis, data mining, advanced Excel, and reporting required
• At least 3 years experience with hospital/provider billing system, EPIC preferred
• At least 3 years experience in healthcare, contract modeling for facility and professional agreements preferred
• Bachelors Degree required

Requirements

• EPIC Certified-2R-EPIC Essential EPIC Resolute Professional Billing Expected Reimbursement Contracts - Time Frame: 1 Year
• EPIC Resolute Hospital Billing Expected Reimbursement Contracts - Time Frame: 1 Year

Benefits

• Employee portion of medical plan premiums are covered after 3 years
• 4%-10% employee savings plan match based on tenure
• Paid Parental Leave (up to 12 weeks)
• Caregiver Leave
• Adoption and surrogacy reimbursement