Managed Care Analyst, Hospital Financial Operations

Community Hospital Corporation•Plano, TX

6d•Onsite

About The Position

Community Hospital Corporation (CHC) is looking for a Managed Care Analyst that will support the Vice President of Health Plan Contracting, providing analytical and contracting support to the Health Plan Contracting function through health plan contract process management, health plan contract review and negotiation. This position sits at the intersection of healthcare finance, insurance claims operations, and legal contract management. Community Hospital Corporation (CHC), recently recognized as a 2026 Dallas Morning News Top Workplaces and named to Becker’s list of 165 Top Places to Work in Healthcare. This is an exciting onsite role at our beautiful corporate offices located in Plano between Legacy West and Grandscape. At CHC we enjoy an outstanding work environment, comprehensive health and welfare benefits including paid fitness facility membership, tuition reimbursement, a generous PTO allowance, free covered parking, and a great company culture. This individual is also responsible for providing analytical support to the CHC Revenue Cycle Team and the CHC affiliated facilities to analyze the patient account receivables (A/R).

Requirements

BBA or BS Degree
Five or more years experience in healthcare financial operations.
Experience working with hospital Electronic Health Records (EHR) and billing systems (e.g., Epic, Cerner, Meditech).
Ability to define and prioritize specific realistic, goals and objectives
Ability to identify, analyze and effectively resolve operational and administrative problems
Ability to work independently and manage multiple projects simultaneously
Ability to be trustworthy
Ability to professionally and successfully interact with a variety of internal and external parties
Communicates openly and in a timely way
Shares information appropriately
Keeps others well informed
Responds in a timely manner to messages/requests
Knowledge of hospital revenue cycle and the impact of such operations on hospital reimbursement
Knowledge of hospital and physician health plan contracts, and the impact of such contracts on hospital operations
Knowledge of all types of healthcare payer sources such as commercial, governmental, workers compensation and others
Proficient understanding and application of the concepts and terminology unique to the healthcare industry
Understanding of electronic files; 837, 835, 277
Understanding of the complete revenue cycle process and the financial implications.
Understanding of Protected Health Information (PHI), along with HIPAA HITECH rules and regulations.
Intermediate level user of Excel and/or Google Sheets

Nice To Haves

Health plan contracting experience preferred.
Medicare and Direct Data Entry (DDE) experience preferred, not required
SQL Report Writing Skills preferred

Responsibilities

Health Plan Contracting Review health plan contracts and identify desired contract modifications in accordance with CHC contract criteria.
Assist in negotiations with payers regarding terms and rates and prepare contracts for final signature.
Audit payments received from managed care companies to ensure accuracy at each hospital against contract terms.
Assist in the maintenance of various databases of contract information.
Interact with client hospitals and health plan representatives to ensure claims payment accuracy.
Revenue Cycle Analysis Identify, investigate, and audit claims variances where actual payer reimbursement does not match the expected contractual amount.
Collaborate with the revenue cycle team to resolve complex claims issues and resubmit corrected claims or appeals.
Work in multiple systems for the hospital and clinic settings to provide the support requires the understanding of each facility's financial data points.
Supporting the CHC Revenue Cycle team with understanding the functionality of claim systems and the associated analytic tools.
Upholds and supports the company’s mission, vision, and values
Perform other miscellaneous job-related duties as assigned by the Vice President of Health Plan Contracting.