Contract and Data Analyst (Managed Care)

Saint Francis Health System

3d•Onsite

About The Position

Responsible for analysis of contracts and performing contract negotiations to include monitoring and reviewing existing contracts to ensure payment compliance, communicating and resolving contract issues both internal and external to the organization, and contributing to health system and individual contract negotiation strategies. Develops and builds contract projections models (EPIC) essential to negotiation outcomes for the health system.

Requirements

Bachelor's Degree in Business or related field required.
Obtain and maintain Epic certification in assigned application module(s).
3 - 4 years related experience.
Experience with health plan insurance contracting and reimbursement for providers.
Experience with Microsoft Access, data warehouse applications, contract negotiations, contract financial modeling, contract language interpretation and EPIC preferred.
Ability to complete Epic certification and maintain certification in assigned application module(s).
Ability to work independently and within a team across multiple disciplines.
Ability to establish and meet work schedules within limited time frames and under tight deadlines.
Analytical ability to solve both business and technical problems.
Working knowledge of Microsoft Excel, Word, and Access.
Excellent interpersonal, written and oral communication skills.
Ability to be detail oriented as required in the analysis and examination of complex information.

Nice To Haves

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

Responsibilities

Analyzes contracts and communicates operational impact of contracts to appropriate health system contacts.
Develop models, analyzes, and monitors financial performance of existing and proposed contracts.
Monitors contract performance and compliance to ensure contracts are performing at expected levels by auditing financials and negotiating with payors for money due if appropriate.
Reviews and negotiates language in the contracting negotiation processes.
Develops, produces, and maintains data sets required for contract analysis.
Develops and maintains departmental processes to manage contracts.
Resolves contractual disputes with payors by collaborating with various health system entities and all related parties.
Responsible for the analysis, development, and testing of contract projection models within Epic essential to negotiation outcomes for the system for both physician and hospital contracts/reimbursement.
Builds programing and performs on going analysis, which maintains the integrity of financial expectations of managed care contracts within the Epic system.
Resolves programming issues related to rate and revenue codes operations through modification to yield maximum revenue potential for both physician and hospital contracts/reimbursement.
Ensures through Epic testing that the build is developed and performing the collaborates with the Epic team to put into production and to enhance contract modeling within Epic.
Performs other related duties as assigned to fulfill department responsibilities.