Managed Care Data Analyst

Sarasota Memorial Health Care System•Sarasota, FL

36d

About The Position

"Working and Living in Paradise" Come join us in beautiful Sarasota, Florida as part of our Managed Care team for Sarasota Memorial Healthcare System. Sarasota is the home one of America's #1 beaches. Located minutes from the beautiful sandy beaches of Florida's West Coast, our Magnet hospital is continuing to grow and expand! Sarasota Memorial Health Care System is a community-owned regional medical center and leading acute care hospital and named by U.S. News & World Report as one of "America's Best Hospitals;" ranking above all other Florida institutions in several specialties. These awards combined with our supportive team environment help to ensure your success. At Sarasota Memorial Hospital, you will be a part of a diverse environment where all people are valued and respected. At Sarasota Memorial's Patient Financial Services Department, you are an individual who's efforts breathe life into the world of the patient financial experience. With many roles and opportunties for professional growth, our Team empowers you to mold your future. Put your best foot forward and submit your application today. Our Managed Care Data Analyst works with Managed Care Analyst Sr to oversee the balancing, reconciling, and resolution of errors for the daily 835 and 837 files, charges, payments, adjustments and contractuals to the patient accounts receivable system. Provides training, guidance, and support with the use of the managed care contracting system by Patient Financial Services (PFS) and other Revenue Cycle team members through education and daily communication. Oversees the Master Tables as assigned and collaborates with the Managed Care team to implement process improvements. Provides guidance and support for other system maintenance functions as required for data integrity of the contract modeling software. Develops reports/report views and explains and interprets data as requested and maintains report libraries. Collaborates with Managed Care Analyst Sr in modeling proposed contracts and loading finalized contracts. Oversees all contract naming conventions, organization of payor models, organization of scanned and paper contracts, rate schedules, payor correspondence, and the managed care smh.com website. Performs other duties as assigned in support of the Managed Care Department.

Requirements

Require a bachelor's degree in a relevant field of study.
Require experience in at least two (2) of the following: Microsoft Excel data analysis, Microsoft PowerPivot / SSAS, Power BI, SQL Server (coding or database maintenance), SSRS, RStudio, Python, PowerShell, or other similar analytics toolset or programming language.

Nice To Haves

Prefer experience in a managed care setting.
Prefer knowledge of health insurance plans and managed care contracts.
Prefer proficient excel user with experience using complex formulas and pivot tables.
Prefer previous experience in generating a variety of reports.
Prefer coding certificate (i.e. CPC) or CPAT/CRCS.
Prefer demonstrated knowledge of hospital billing, including hospital charges, CPT, DRG, APC, APRDRG, revenue codes, and ASC Groupers
Prefer demonstrated knowledge of contract modeling software, contract terms, and contract modeling.
Prefer demonstrated ability to relate to a wide variety of people using excellent written and verbal communication skills.
Prefer demonstrated organizational, analytical, leadership and judgment skills.
Prefer demonstrated proficiency with Windows-based office applications including Excel, Word, PowerPoint, Access, and Outlook.
Prefer knowledge and experience with hospital and physician billing, payer claims adjudication and analyzing payment patterns.

Responsibilities

Oversee the balancing, reconciling, and resolution of errors for the daily 835 and 837 files, charges, payments, adjustments and contractuals to the patient accounts receivable system.
Provides training, guidance, and support with the use of the managed care contracting system by Patient Financial Services (PFS) and other Revenue Cycle team members through education and daily communication.
Oversees the Master Tables as assigned and collaborates with the Managed Care team to implement process improvements.
Provides guidance and support for other system maintenance functions as required for data integrity of the contract modeling software.
Develops reports/report views and explains and interprets data as requested and maintains report libraries.
Collaborates with Managed Care Analyst Sr in modeling proposed contracts and loading finalized contracts.
Oversees all contract naming conventions, organization of payor models, organization of scanned and paper contracts, rate schedules, payor correspondence, and the managed care smh.com website.
Performs other duties as assigned in support of the Managed Care Department.

Benefits

Paid Time Off (start earning PTO on day one of employment)
Tuition Reimbursement
Discounted Medical, Prescription, Dental, Vision Benefit Plans for Full & Part-Time Employees
Flexible Spending Accounts (Health Care and Dependent Care) - Pre-Tax Dollars
Life Insurance
Competitie rates
Bonuses offered
Disability Insurance
Retirement Savings Plan: 403b
Sarasota Campus for now - Discounted Child Care & Before and After School Program and Summer Camp!
Bereavement Leave
Free Parking
On Campus Dining w/ a 10% discount
Credit Union w/ teller machines on campus
Direct Deposit
Free Wellness Screening
Free confidential counseling services
Employee Discount Programs
Recognition Programs
Referral Programs
Tremendous growth opportunities for hard workers!