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Senior Managed Care Contracting Analyst

Company: Tandym Group
Location: Hollywood
Posted on: September 20, 2022

Job Description:

A healthcare system in Florida is actively seeking an experienced and dedicated professional to join their staff as a Senior Managed Care Contracting Analyst. In this role, the Senior Managed Care Contracting Analyst will develop complex analytics for value-based agreements. Responsibilities The -Senior Managed Care Contracting Analyst will:

  • Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by the negotiators -
  • Analyze terms of new and existing risk and non-risk contracts and/or amendments/modifications using approved model contract language
  • Prepare complex service line reimbursement analysis and financial performance analysis using a broad spectrum of healthcare data
  • Develop methods and models to identify the implications of a wide variety of new/revised strategies, approaches, provisions, and rate structures aimed at establishing appropriate reimbursement levels
  • Manage the detailed analysis, design, coding, testing, implementation and maintenance of reports, dashboards, and other delivery methods used to support managed care business analytics Qualifications
    • Bachelor's degree
    • 5+ years of experience in healthcare pricing, medical economics or related discipline
    • Extensive knowledge of healthcare/medical economics data such as hospital/physician /ASC claims, utilization data, various payment methodologies, various types of fee schedules(such as CMS) and healthcare industry coding systems ICD-10, CPT/HCPCS, Revenue Codes, MS/APR-DRGs and APCs
    • Advanced proficiency working with business intelligence tools which include MS-SQL, Tableau, and MS Excel
    • Extensive experience working with large databases and complex data sets and be able to identify data gaps and make reasonable assumptions where necessary to summarize data

Keywords: Tandym Group, Hollywood , Senior Managed Care Contracting Analyst, Professions , Hollywood, Florida

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