MANAGED CARE ANALYST
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POST DATE 9/2/2016
END DATE 12/17/2016
JOB DESCRIPTIONJob Details:
* Bachelors degree is required
The Managed Care Analyst is responsible for the development, implementation and maintenance of procedures which provide administrative, analytical, negotiation and public relations support to the Finance Division under the supervision of the Director of Finance and Managed Care.
RESPONSIBILITIES INCLUDE BUT ARE NOT LIMITED TO:
*Commits to the mission, vision, beliefs and consistently demonstrates our core values.
*Analyzes and negotiates contract rates with insurance plans.
*Orders reports, analyzes statistics and prepares a summary of pertinent data to evaluate contracts which are due for renegotiation and generates reports as requested by other departments.
*Monitors and analyzes various aspects of contract reimbursement and performs analysis on differences between expected and actual reimbursement.
*Generates reports used to oversee third party payer activity; researches and corrects any discrepancies; maintains a log of all underpayments and overpayments.
*Provides information regarding payment discrepancies to PFS; participates in activities to identify and resolve patterns of incorrect payments by third party payers; contacts and resolves incorrect payments with payers.
*Analyzes denials and follows up on identified discrepancies; works with other areas to resolve any patterns or issues.
*Creates and/or modifies managed care contracts using programming logic when new contracts or changes occur; ensures accuracy within the Payment Integrity Compass (PIC).
Bachelor's degree in Business or health related field required. Minimum of three (3) years related health care experience required. Minimum of one (1) year contract management experience preferred.
Bryan Health is an Affirmative Action/Equal Employment Opportunity Employer. Employment decisions are made without regard to race, religion, age, color, sex, national origin, disability, genetics, marital, disability and/or veteran status. Bryan Health hires and promotes individuals solely on the basis of their qualifications for the job to be filled.