Full Job Description
ResponsibilitiesThe Senior Managed Care Analyst is responsible for the development and execution of data driven strategies and is accountable for the successful achievement of decision support objectives in the areas of contract modeling, financial/service line/volume analysis, data, and system integrity. Produce timely and accurate analysis based on clinical and financial knowledge in healthcare to maximize reimbursement and achieve strategic advantages in contract negotiations. Develop and maintain contract modeling in applicable software including building service type definitions, rate schedules, stop-loss, and other contract negotiated rates. Coordinate mapping of benefit plans. Provide education to analysts and other CHS stakeholders in contract language and identify issues for operational changes within processes to improve the management of resources and to make sound financial decisions. Participate in project teams and special assignments to support decision making processes throughout the organization.
Qualifications
Education
• High School Diploma, High School Equivalency (HSE), or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
• Bachelor's Degree in Business or Healthcare Administration required
• 10 years of experience in contract modeling, contract analysis, healthcare billing process, and 2 years of experience in the healthcare insurance industry may be substituted for Bachelor's Degree and experience requirements
Experience
• 3 years of experience in contract modeling or healthcare analytics required
• 5 years of experience in contract analysis required
Licenses and Certifications
• EPIC - Epic Certification preferred
Disclaimers
• Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.
