Managed Care Analyst 2

Sutter Health•Sacramento, CA

2d•Onsite

About The Position

This position includes responsibility for negotiating patient-specific Letters of Agreements for reimbursement rates with non-contracted payers to provide access to patients under the direction of Managed Care Department leaders. In addition, this position will support Manager Care leaders with managing negotiation documents, making edits, providing overlay comparisons of proposal documents and resolving issues with Payers for operational units within Sutter. Serves as intermediary between Payers and Sutter related to disputed payments and other projects. This position will also support the Managed Care Department related other projects, such as department training materials, Payer claims research and contract compliance.

Requirements

Bachelor's degree in Accounting, Finance, Economics, Statistics, Business or Healthcare Administration or related field, or equivalent experience.
2 years recent relevant experience.
Knowledge of managed care payment/reimbursement methodologies (e.g., Medicaid/Medi-Cal, Medicare, fee-for-service, capitation/sub-capitation) for various types of healthcare entities (e.g., hospital, skilled nursing facilities, physician, ancillary and professional service providers).
Familiarity with healthcare contracting terminologies.
Familiarity with healthcare/hospital operations and structure.
Knowledge of CMS, DHCS, DMHC requirements for providers.
Organizational skills and attention to detail.
Ability to read, comprehend, interpret and apply policies, procedures, practices, contract language, and regulatory and legal requirements, including financial reports.
Customer service focus in all decisions and actions.
Ability to prioritize workload to complete assignments accurately and timely, and to meet strict timelines.
Ability to communicate through verbal and written means, and to present information to a variety of audiences.
Ability to interact and maintain effective working relationships with those contacted in the performance of required duties.
Demonstrates respect for cultural and linguistic differences and promotes an inclusive work environment.

Responsibilities

Negotiating patient-specific Letters of Agreements for reimbursement rates with non-contracted payers.
Supporting Managed Care leaders with managing negotiation documents, making edits, and providing overlay comparisons of proposal documents.
Resolving issues with Payers for operational units within Sutter.
Serving as an intermediary between Payers and Sutter related to disputed payments and other projects.
Supporting the Managed Care Department with department training materials, Payer claims research, and contract compliance.