Contract and Data Analyst Managed Care

About This Role

Analyze and negotiate managed care contracts, ensuring payment compliance and resolving issues. Develop and build contract projection models using Epic to support negotiation outcomes for the health system.

Responsibilities

• Analyze contracts and communicate operational impact to health system contacts
• Develop models, analyze, and monitor financial performance of existing and proposed contracts
• Monitor contract performance and compliance, auditing financials and negotiating with payors for money due
• Review and negotiate language in the contracting negotiation processes
• Develop, produce, and maintain data sets for contract analysis
• Develop and maintain departmental processes to manage contracts
• Resolve contractual disputes with payors by collaborating with various health system entities
• Analyze, develop, and test contract projection models within Epic for negotiation outcomes
• Build programming and perform ongoing analysis to maintain financial expectations of managed care contracts within Epic
• Resolve programming issues related to rate and revenue codes operations through modification to yield maximum revenue potential

Requirements

• Three (3) - four (4) years of related experience
• Experience with health plan insurance contracting and reimbursement for providers and facilities
• Ability to complete Epic certification and maintain certification in assigned application modules(s)
• Strong analytical ability to solve business and technical problems
• Working knowledge of Microsoft Excel, Word, Power BI and Access
• Excellent interpersonal, written and oral communication skills
• Ability to be detail oriented in the analysis and examination of complex information

Qualifications

• Bachelor's degree in business or related field
• 3-4 years of related experience

Nice to Have

• Experience with Microsoft Access, data warehouse applications, contract negotiations, contract financial modeling, contract language interpretation and EPIC

Skills

* Required skills

Certifications