Financial and Contracts Systems Analyst Managed Care

Children's Wisconsin • West Allis, WI

5d

About The Position

The Managed Care Financial & Contracts Systems Analyst is responsible for maintaining the integrity of expected reimbursement calculations within Epic's Professional Billing module. This role combines technical Epic build expertise with financial analysis skills to ensure accurate estimated reimbursement is depicted in the Epic electronic health record by building, maintaining, and optimizing professional billing contracts within the Epic electronic health record system and performing financial analyses and building financial models to ensure contract compliance. Also supports financial planning needs for contract negotiations with various financial models and analyses and providing general financial analyses that inform and support strategic initiatives, operational efficiency and financial sustainability insights and decisions, as assigned.

Requirements

• Bachelor's Degree in Finance, Healthcare Administration, Business, or related field required or relevant experience.
• 2+ years of experience in a healthcare finance-related function OR high school diploma AND 5+ years of experience in a healthcare finance-related function required.
• Strong analytical skills with the ability to interpret complex contract language.
• Proficiency with data modeling, analysis and visualization tools - including complex formulas and data analysis.
• Excellent problem-solving abilities and attention to detail.
• Ability to interpret contract language and translate into technical requirements.
• Familiarity with both Medicaid and Commercial payer reimbursement methodologies (fee schedules, percent of charge, carve-outs, grouper-based logic).
• Strong written and verbal communication skills.
• Epic PB Contracts experience or certification OR willingness to obtain certification within one year of hire.

Nice To Haves

• Experience in healthcare contract modeling and optimization preferred.
• Experience in financial modeling and contract analysis preferred.
• Experience with healthcare professional billing and reimbursement methodologies and workflows preferred.
• Understanding of payer contracts and reimbursement models preferred.

Responsibilities

• Maintaining the integrity of expected reimbursement calculations within Epic's Professional Billing module.
• Building, maintaining, and optimizing professional billing contracts within the Epic electronic health record system.
• Performing financial analyses and building financial models to ensure contract compliance.
• Supporting financial planning needs for contract negotiations with various financial models and analyses.
• Providing general financial analyses that inform and support strategic initiatives, operational efficiency and financial sustainability insights and decisions, as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level