Managed Care Analyst

Mosaic Life Care • Saint Joseph, MO

5d • $68,182 - $102,274

About The Position

This position works under the direction of the Director- Managed Care. Accountable for the evaluation, negotiation, administration and communication regarding commercial, governmental and direct employer agreements. This position is also responsible for net revenue analysis, rate negotiations, and monitoring of contract performance through periodic evaluation and audits of contract payments. This position is employed by Mosaic Health System.

Requirements

• BS degree in accounting, finance, or related field, from an accredited college or university or equivalent work experience.
• Prior experience and knowledge in the use of software packages such as Microsoft Excel, Word, Access, and Windows.
• Three years healthcare or related experience in financial analysis required.

Nice To Haves

• Prior experience and knowledge in negotiating contractual and financial terms for managed care agreements, preferred.

Responsibilities

• Evaluates reimbursement methodologies, language and payor policy to determine financial impact to the organization under the direction of management.
• Participate in contract discussions regarding language and reimbursement to meet the overall needs of the organization
• Develop reliable financial models to estimate reimbursement and policy changes on the finances of the organization.
• Understand and analyze the key drivers for denial management under the direction of management.
• Develop relationships with key health plans. Participate in discussions re: contracting needs, contract interpretation, claims/denials issues and how to improve the overall relationship.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees