Managed Care Analyst, Sutter Senior Care, Limited Term

Sutter Health • Sacramento, CA

2d • $38 - $57 • Hybrid

About The Position

Hybrid position with report requirements in Sacramento, Ca regularly. Successful candidate will have Medical data analyst experience, preferably in a Home Health/Hospice environment. Provides data and analyses, including financial modeling and forecasting, to support contract negotiations and administration for affiliates. Creates periodic reports relating to payer performance, utilization, reimbursement and other clinical and financial data to assess and monitor contract/payer performance, identifying trends and patterns.

Requirements

• Bachelor's: Accounting, Finance, Economics, Statistics, Business or Healthcare Administration or related field
• 2 years recent relevant experience
• Knowledge of financial modeling and financial analysis principles, methods, practices, and procedures.
• 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).
• Knowledge of healthcare/hospital accounting systems and audit processes.
• Familiar with healthcare contracting terminologies.
• Knowledge of healthcare/hospital operations and structure.
• Knowledgeable of the unique operational and financial reporting requirements that include incurred but not reported (IBNR) calculations/adjustments, Division of Financial Responsibility (DOFR) assessment and valuation, modeling and assessing plan health factors and population normalization principles.
• Ability to translate financial data and analysis into reports and presentations for appropriate audience.
• Critical thinking and quantitative analytical abilities to work with large and complex data sets.
• Organization skills and attention to details.
• Ability to read, comprehend, interpret and apply policies, procedures, practices, contract language, and regulatory and legal requirements, including financial reports.
• Displays a 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.
• Demonstrates initiative in providing feedback/input to improve workflow/processes.
• Ability to work effectively in a dynamic and fast-paced environment with changing business priorities.
• Ability to maintain and work discreetly with confidential information.
• Ability to use essential applications and/or databases associated with the role’s duties and responsibilities.

Responsibilities

• Provides data and analyses, including financial modeling and forecasting, to support contract negotiations and administration for affiliates.
• Creates periodic reports relating to payer performance, utilization, reimbursement and other clinical and financial data to assess and monitor contract/payer performance, identifying trends and patterns.

What This Job Offers

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