Managed Care Contract Analyst

🕒 6 dias atrás

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $65.000 - $75.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🧐 Analista

👻 Score fantasma 0%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

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Ob Hospitalist Group

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2006

🏥 Saúde

💊 Farmacêutico

Healthcare • Pharmaceuticals

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Descrição

• Support managed care contracting strategies for Obtelecare programs • Conduct payer research and track contracting opportunities • Support contract implementation and agreement maintenance • Review, interpret, and summarize payer agreements, reimbursement terms, billing requirements, credentialing requirements, payer enrollment details, state-specific provisions, and contract notice provisions • Evaluate fee schedules, reimbursement terms, payer behavior, underpayments, trends, and variances • Maintain contract summary sheets, fee schedule crosswalks, payer lists, rosters, contract status reports, workflow metrics, and other contracting documentation • Partner with Revenue Cycle Management, operations, credentialing, payer enrollment, and payer representatives to resolve escalated claims, reimbursement, and contract interpretation issues • Create ad-hoc reports and data analyses related to payment trends, denials, payer performance, reimbursement variances, and contract-related opportunities • Maintain contract-related training materials, reference documents, and process guides • Securely manage contract documentation, payer information, and Protected Health Information in accordance with company policies and regulatory requirements

🎯 Requisitos

• Minimum of 5 years of experience in managed care contracting, payer relations, provider relations, revenue cycle, or healthcare contracting • Strong understanding of Revenue Cycle Management, managed care contract language, reimbursement methodologies, payer operations, contract interpretation, and healthcare regulatory considerations • Ability to analyze complex payer agreements, identify reimbursement or process improvement opportunities, research payer issues, and recommend solutions • Excellent analytical, organizational, communication, documentation, and follow-up skills with strong attention to detail • Proficiency with Microsoft Word, Excel, and contract or revenue cycle systems • Bachelor’s degree in business administration, accounting, finance, healthcare, or a related field preferred; equivalent work experience may be considered • Experience with healthcare analytics, contract modeling, reimbursement analysis, reporting tools, ECHO, data warehouse reporting, or advanced Excel is a plus • Ability to handle contract documentation, payer information, and Protected Health Information securely and in alignment with company policies and regulatory requirements

🏖️ Benefícios

• Full-time, benefit eligible • Paid time off and holidays • Medical, dental, and vision insurance • Health Savings Account with employer contribution • Flexible Spending Account options • Employer-paid basic life and AD&D insurance • Employer-paid short- and long-term disability • Optional short-term disability buy-up plan • Paid parental leave • 401(k) savings plan with match • Legal plan and identity theft services • Mental health support and resources • Mission-based company culture • Occasional travel may be required for meetings, training, or business needs