This position reports to the Director of Decision Support and Analytics and is responsible for the management and analysis of Managed Care initiatives including the extraction and analysis of data impacting the Managed Care Payor Contracts, (Medicare performance, Medicaid, Managed Care, Commercial), accounts receivable, denials, and payor contract performance. The Managed Care and System Support Analyst will collaborate with other key functions including healthcare center financial, clinical departments, and revenue cycle business services, as well as regional and corporate services. This exciting position may have opportunities to work on emerging Managed Care issues and special projects. This position is also responsible for supporting and ensuring the integrity of data coming into and out of managed care. These tasks can include reconciling data between systems, completing proformas and operational analytics all while maintaining a high level of service for the customer base.
Implement and document best practice policy and procedures for ad-hoc reporting, validation and all related process essential to creating streamlined managed care and system reporting.
Supports the Managed Care team in financial analysis and contract improvement
Participates on special Managed Care projects such as Evaluation of Contract Performance, Budget Analysis, Market Performance, Under payment/Over payment Review
Extracts and analyzes data from health information, decision support, and EHR systems
Contribute to system design and integration recommendations for improvement for all used systems
Provides timely and accurate analysis to enhance revenue cycle process outcomes
Performs statistical, cost and financial analysis of data extracted from various internal sources. Prepares reports based on findings, including health care costs, provider contracts, revenue and profitability.
Researches a variety of complex issues impacting Managed Care revenue and recommends processes to enhance financial performance
Prepares reports evaluating the performance of Managed Care contracts
Performs research on best practices and national benchmarks for the healthcare industry
Contributes to the successful implementation of Managed Care projects
Performs other duties and special projects as assigned
Bachelors or Masters Degree, preferably in Business or Finance preferred
Ability to work independently with minimal supervision as well as ability to work in a team environment
Skilled at managing multiple projects with various customers and grasp new concepts
Proficient in extracting data from data sources and is detail-oriented
Strong analytical skills to perform complex analyses
Possess effective problem solving skills and a positive "can-do" attitude
Advanced knowledge of healthcare industry with emphasis on Managed Care contract terminology (i.e., DRG, Per Diem, Case Rate, ICD10)
Accurately complete assignments while meeting deadlines
Excellent organizational skills
Excellent oral and written communication skills
Ability to interface with all levels of personnel in a large organization
Proficient in Microsoft Office products including Excel, Word, Power Point, MS Project
4 plus years advanced experience in hospital contract modeling
4 plus years advanced experience in physician and ancillary contract modeling, (i.e.
Experience with hospital account reconciliations and reimbursement methodologies
Ad-Hoc reporting experience with skills in extracting and analyzing appropriate data
Understanding of revenue cycle operations including high dollar, claim disputes, denials, system logic, and plan edits
Demonstrated leadership in teamwork, special projects and complex assignments
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.