Managed Care Analyst, Financial Admin, Full Time, Day

Summary

Valley Health System is a healthcare organization seeking a Managed Care Analyst to support payor contracting and financial analysis. The role analyzes claims, denials, payments, revenue forecasts, contract models, and payer compliance while advising stakeholders on regulatory and insurance industry changes.

Responsibilities

• This position supports activities of payor contracting and analysis for the Valley Health System
• This position assists with enterprise-wide managed care contracting initiatives through analysis of claim and denial/payment trends and provides oversight of payer contract compliance for the system
• This position is also a key resource to system stakeholders on new regulatory and legislative developments pertaining to the Federal Price Transparency and the No Surprises Act legislations
• The position provides analytical support to other areas within the system (VMG, Population Health, ColigoCare, etc.) as it pertains to revenue forecasting, contract modeling, denial and payment variance analysis and trends
• This position also serves as a one of the key subject matter experts for the system for any education related to insurance industry changes, managed care regulation, and impactful payer policies/protocol changes

Skills

• Bachelor's degree in economics, business administration, health care administration or related subject is required
• A minimum of two years' experience with payor or provider contracting in a health care setting, knowledge of the healthcare industry and payor reimbursement methodologies
• Excellent analytical skills, with attention to detail and accuracy required
• Strong communication and interpersonal skills required
• Excellent written, organizational, and critical thinking skills required
• MBA or MHA degree preferred

Qualifications

Must Haves

• Bachelor's degree in economics, business administration, health care administration or related subject is required
• A minimum of two years' experience with payor or provider contracting in a health care setting, knowledge of the healthcare industry and payor reimbursement methodologies
• Excellent analytical skills, with attention to detail and accuracy required
• Strong communication and interpersonal skills required
• Excellent written, organizational, and critical thinking skills required

Nice to Haves

• MBA or MHA degree preferred

Benefits

• Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees)
• Group Term Life Insurance and AD&D (Full Time Employees)
• Flexible Spending Accounts and Commuter Benefit Plans
• Supplemental Voluntary Benefits (e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.)
• 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness
• Retirement Plan
• Tuition Assistance
• Employee Assistance Program (EAP)
• Valley Health LifeStyles Fitness Center Membership Discount
• Day Care Discounts for Various Daycare Facilities