Reimbursement & Incentives Analyst II

Medica • Minnetonka, MN

272d • $55,400 - $95,000

About The Position

The Reimbursement and Incentives Analyst II will be responsible for supporting both the fee schedule development and implementation processes for the fee schedule team. The analyst will work to document processes, dependencies, and tools to maintain Medica's provider fee schedules and work with stakeholders on identifying refinement opportunities. Additionally, the analyst will be responsible for supporting contract model data inputs, stewardship of provider finance data, and working with stakeholders to identify opportunities to improve model functionality, efficiency, and accuracy. The analyst will assist in the successful operation of the fee schedule team. This individual ensures that processes and policies are followed to produce high quality results. The analyst proactively engages on identified opportunities and facilitates solutions with various stakeholders.

Requirements

• Bachelor's degree or equivalent combination of education and experience.
• 3 years of experience working in Healthcare OR Healthcare Payer required.
• Healthcare reimbursement experience preferred.

Nice To Haves

• Preferred SQL and SAS experience but not required.

Responsibilities

• Fee schedule development and implementation including uploading new fee schedules, tracking fee schedule activity, and facilitating fee schedule provider renewal impacts and coding updates.
• Documenting processes, dependencies, and tools to maintain fee schedules in Medica's provider reimbursement payment platforms.
• Knowledge with Ancillary reimbursement including: Home Health Care, Durable Medical Equipment, Home Infusion Therapy, etc.
• Support provider contract modeling solutions and contract modeling inputs including but not limited to Datapac inputs.
• Work together with key stakeholders to optimize Medica's provider negotiation model process through the promotion of refinements to improve model functionality, efficiency, and accuracy.
• Promotes and participates in efforts focused on data stewardship and best practices.
• Provide support to expansion growth on the Medicare/Medicaid initiatives as a subject matter expert.
• Interacts heavily with team members and other departments. Builds strong relationships with groups across the organization, including: Network Management, Provider Network Operations, and IT.
• Provides support to network management strategic initiatives.
• Assists with other provider finance activities such as supporting Medical Expense Committee, Reimbursement Committee, & commercial RFP.

Benefits

• Competitive medical, dental, vision insurance.
• Paid time off (PTO) and holidays.
• Paid volunteer time off.
• 401K contributions.
• Caregiver services.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Professional, Scientific, and Technical Services
• Education Level: Bachelor's degree