Job DescriptionThe Supervisor - Managed Care Analysis supports the financial analysis, modeling, and implementation of managed care contracts within Epic. This role translates contract terms into accurate reimbursement models, evaluates contract performance, and supports payer negotiations through data-driven insights. The position partners closely with Managed Care, Revenue Cycle, Finance, and Epic application teams to ensure contract accuracy, optimal reimbursement, and revenue integrity.
Responsibilities- Supervises team members, which includes orientation, development and evaluation of team members, and monitoring the provision of delivering quality services. Participates in the recruiting, interviewing, and selecting of team members following policies, guidelines and applicable laws. Ensures training for new team members and retraining. Supports evaluation of team member's performance relative to job goals and requirements. Provides coaching to staff, recommends education programs, and ensures adherence to internal policies and standards.
- Develops and maintains financial models for proposed and existing managed care contracts.
- Models complex reimbursement methodologies including DRG, APC, per diem, case rates, and fee schedules.
- Analyzes contract financial impact to support payer negotiations and leadership decision-making.
- Performs expected vs. actual reimbursement variance analysis.
- Translates executed contract language into Epic reimbursement contract build.
- Configures and maintains expected reimbursement and fee schedules in Epic.
- Performs Epic testing and validation prior to production release.
- Partners with Epic application teams to resolve reimbursement discrepancies.
- Monitors managed care contract performance and identify underpayments.
- Supports audits, reconciliations, and payer disputes.
- Collaborates with Managed Care, Revenue Cycle, Finance, and Operational teams.
- Communicates complex reimbursement concepts to non-technical stakeholders.
QualificationsMinimum Education- Bachelor's Degree Business, Finance, Health Care Administration, Related field Required or
- Four years of related experience may be considered in lieu of degree Required
Minimum Work Experience- 3 years' Experience in managed care contract modeling or healthcare financial analysis experience. Required
- 1 year Experience in Epic reimbursement modules. Preferred
- 1 year Experience supporting payer negotiations and renewals. Preferred
- 1 year Experience in a multi-facility health system. Preferred
- 1 year Experience with Medicare, Medicaid, and commercial reimbursement Preferred
Licenses and Certifications - Epic certification(s) in relevant modules. Upon Hire Preferred
Required Skills, Knowledge and Abilities - Strong understanding of healthcare reimbursement methodologies.
- Advanced Excel skills.
- Demonstrated proficiency in reimbursement modules.
- Knowledge of healthcare revenue cycle operations and workflows.
- Excellent written and verbal communication skills.
- Ability to work collaboratively with diverse teams.
- Strong ability to analyze, interpret, and evaluate data.
