Senior Managed Care Reimbursement Analyst

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $71.1k - $97.8k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

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Franciscan Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1875

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Franciscan Health is a healthcare organization committed to providing high-quality medical care grounded in the Franciscan tradition. They offer a range of medical services, including clinical and allied health, home health and hospice, nursing, physicians and advanced practice providers, and non-clinical and administrative roles. With a focus on embracing the values of St. Francis to care for those in need, they provide a supportive and fulfilling work environment for their employees, emphasizing a mission of compassion and community engagement. Franciscan Health is dedicated to offering a variety of employment opportunities across different medical specialties and locations.

📋 Description

• Work with Facility Information Systems and Health Information Management to extract data for ongoing analysis of account-based reimbursement transactions • Analyze Facility Managed Care contracts and reconcile them to payments received • Make recommendations to prevent future cash losses • Support reimbursement strategies and initiatives through analysis of performance objectives • Assess changes for migration from fee-for-service reimbursement to risk-based reimbursement/capitation • Manage reports monitoring variances between managed care contracts • Compare expected reimbursement rates by site and service and benchmark against other payment rates, such as Medicare • Develop financial and planning models for reimbursement initiatives, contracts, amendments, payment disputes, regulatory changes, and provider manual changes • Perform reimbursement modeling for strategic projects, services, and managed care contract scenarios • Conduct strategic reimbursement modeling to support charge master changes • Access rate schedules, product details, and historical claims to build and deploy model scenarios • Synthesize data, opportunities, issues, and challenges; articulate findings, conclusions, and recommendations

🎯 Requirements

• 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 of Reimbursement/Analyst experience — Required • 5 years of Healthcare Managed Care Modeling experience — Required • EPIC Certified or Accredited; EPIC obtained within 180 days — Required • Travel is required: Never or Rarely

🏖️ Benefits

• Comprehensive benefit offerings for eligible employees • Travel is required never or rarely