[Hiring] Senior Managed Care Reimbursement Analyst @Franciscan Alliance, Inc.

Role Description

At Franciscan, our Senior Managed Care Reimbursement Analysts work with the Facility Information Systems and Health Information Management to extract the data necessary to perform ongoing analysis of all account-based, reimbursement transactions for accuracy. The position analyzes Facility Managed Care contracts, reconciles to payments received, and makes recommendations to prevent future cash losses.

• Support the System’s reimbursement strategies and initiatives through analysis of performance objectives and assessment of changes necessary for migration from a fee-for-service reimbursement to a risk-based reimbursement/capitation environment.
• Management of reports to monitor variances between managed care contracts, compare expected reimbursement rates by site and service, and benchmark to other payment rates (e.g. Medicare).
• Develop financial and planning models to evaluate the impact of proposed reimbursement initiatives, contracts, amendments, payment disputes, and changes in regulation or provider manuals.
• Perform reimbursement modeling for new strategic projects or services and with managed care contract scenario modeling.
• Conduct the strategic reimbursement modeling to support changes to the charge master.
• Access rate schedules, product details, and historical claims to build and deploy model scenarios. Leverage multiple data points to provide visibility into all key model components.
• Synthesize data, opportunities, issues/challenges, and articulate findings, conclusions, and recommendations.

Qualifications

• Bachelor's Degree in Business, Statistics, Information Systems, Healthcare Management or related - Required
• Master's Degree in Business, Statistics, Information Systems, Healthcare Management or related - Preferred
• 7 years Reimbursement/Analyst - Required
• 5 years Healthcare Managed Care Modeling - Required
• EPIC Certified or Accredited - EPIC obtained within 180 days - Required

Requirements

• Travel is required: Never or Rarely
• Job Range: Senior Managed Care Reimbursement Analyst $71,100 - $97,760
• Incentive: Not Applicable

Equal Opportunity Employer

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity.

Benefits

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.