Senior Managed Care Reimbursement Analyst
Franciscan Alliance, Inc.
•$71,100 - $97,760•Remote
About The Position
At Franciscan, our Senior Managed Care Reimbursement Analysts work with the Facility Information Systems and Health Information Management to extract the data necessary to perform ongoing analysis of all account-based, reimbursement transactions for accuracy. The position analyzes Facility Managed Care contracts, reconciles to payments received, and makes recommendations to prevent future cash losses.
Requirements
- Bachelor's Degree Business, Statistics, Information Systems, Healthcare Management or related - Required
- 7 years Reimbursement/Analyst - Required
- 5 years Healthcare Managed Care Modeling - Required
- EPIC Certified or Accredited - EPIC obtained within 180 days - Required
Nice To Haves
- Master's Degree Business, Statistics, Information Systems, Healthcare Management or related - Preferred
Responsibilities
- Support the System’s reimbursement strategies and initiatives through analysis of performance objectives and assessment of changes necessary for migration from a fee-for-service reimbursement to a risk-based reimbursement/capitation environment.
- Management of reports to monitor variances between managed care contracts, compare expected reimbursement rates by site and service, and benchmark to other payment rates (e.g. Medicare).
- Develop financial and planning models to evaluate the impact of proposed reimbursement initiatives, contracts, amendments, payment disputes, and changes in regulation or provider manuals.
- Perform reimbursement modeling for new strategic projects or services and with managed care contract scenario modeling.
- Conduct the strategic reimbursement modeling to support changes to the charge master.
- Access rate schedules, product details, and historical claims to build and deploy model scenarios. Leverage multiple data points to provide visibility into all key model components.
- Synthesize data, opportunities, issues/challenges, and articulate findings, conclusions, and recommendations.
Benefits
- Comprehensive benefit offerings
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Senior
