Senior Analyst, Managed Care
Summary: This position will be responsible for a variety of functions under the Managed Care Department including building and helping to maintain managed care reports, contract database maintenance, and contract analysis. Other key responsibilities include assistance in negotiating contracts with payers, revenue/rate modeling, and support with systemic payer issues.
- Create and regularly maintain department standard reporting for all markets including facility and physician rate summaries, contract summaries, and payor/product grids, in excel by region, by state, by facility, as applicable
- Load payer contracts, rate sheets, fee schedules and other documents into the new managed care database (OnBase)
- Understand, interpret, and summarize provisions and obligations contained in Steward’s contracts with various health plans with support from more senior managed care staff
- Be a key resource for others in the organization regarding rates, the managed care database, and database reporting
- Help maintain the integrity of the database on an ongoing basis, proactively working to assess gaps and recommend solutions
- Assist with department policy maintenance and revisions
- Perform managed care contract analytics (such as fee schedule analysis and revenue modeling) and other ad hoc projects as requested under the supervision of more senior level managed care staff
- Assist senior contract managers in negotiating contracts with payers and resolving systemic payor issues
Education: Bachelor’s degree required in related fields.
Experience: 1-3 years work experience
Software/Hardware: MS Office proficiency required, advanced abilities in excel strongly preferred
Other: Understanding of the health care delivery system.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled