Managed Care Analyst
$63.33kUniversity of Texas at Austin
Job Posting Title: Managed Care Analyst Hiring Department: Dell Medical School Position Open To: All Applicants Weekly Scheduled Hours: 40 FLSA Status: Exempt from FLSA Earliest Start Date: Immediately Position Duration: Expected to Continue Location:
AUSTIN, TX
---- Job Details:PURPOSE
The Managed Care Analyst plays a pivotal role in driving strategic decision-making across the health system by capturing, transforming, interpreting, and presenting complex healthcare data. This position leads analytics related to payer contracting, payment modeling, and revenue cycle key performance indicators (KPIs), providing critical insights that support successful contract negotiations and ongoing payer performance monitoring. Reporting to the Assistant Director of Managed Care Contracting, the Analyst partners with teams across Revenue Cycle, Finance, Clinical Operations, and Executive Leadership. Leveraging advanced data tools and EMR systems, the Analyst delivers actionable intelligence that enhances financial outcomes, operational efficiency, and patient access to care.RESPONSIBILITIES
Leads Payment Modeling and Contract Analytics Models commercial and government payment methodologies for physician, ambulatory, and hospital services. Analyzes contract proposals using reimbursement methods such as fee schedules, DRG, case rates, and stop-loss. Leverages tools like Experian MPV and FinThrive for enhanced contract modeling. Synthesizes contract terms to support negotiation strategies. Evaluates contract performance and compliance. Transforms Data into Strategic Insights Extracts and interprets data from EMRs (e.g., Epic, Athena) and financial systems. Develops dashboards and reports for Managed Care, Revenue Cycle, and Executive stakeholders. Identifies risks and opportunities in payer performance and reimbursement. Synthesizes complex datasets into actionable recommendations. Supports strategic initiatives with data-driven insights. Analyzes Revenue Cycle KPIs Monitors key performance indicators related to claims, denials, and payments. Identifies trends in overpayments, underpayments, and global denials. Collaborates with Revenue Cycle teams to resolve payer issues. Uses EMR reporting capabilities to enhance decision-making. Supports compliance and audit readiness. Communicates Effectively with Stakeholders Prepares and presents findings to department and executive leadership. Translates complex analytics into clear, actionable insights. Serves as liaison between internal teams and external payers. Participates in cross-functional meetings and payer summits. Supports education and training on managed care analytics. Maintains Industry Knowledge and Adapts to Change Monitors changes in reimbursement models and payer policies. Conducts market research on healthcare trends and regulations. Attends professional development events and webinars. Evaluates emerging technologies and analytics tools. Adapts to evolving payer environments and contract structures. Supports System Enhancements and Upgrades Represents department needs in EMR system maintenance and upgrades. Collaborates with IT and vendor teams to optimize reporting tools. Tests and validates system changes related to managed care analytics. Documents system requirements and workflows. Provides feedback for continuous improvement.REQUIRED QUALIFICATIONS:
Bachelor's Degree in Data Science, Analytics, Health Administration, Public Health, Finance, or a related quantitative or healthcare discipline At least 4 year(s) of experience in managed care analytics, healthcare finance, payer contracting or a related field. Advanced knowledge of commercial and government reimbursement, managed care contracting, fee schedules, revenue cycle management, and EMR software systems such as Epic. Relevant education or experience may be substituted as appropriate.PREFERRED QUALIFICATIONS:
Master's Degree in Health Administration, Public Health, Business, or Data Analytics with at least 7 year(s) of experience in managed care analytics or contract negotiation. Experience in academic medical center or large integrated health system. Certified Professional in Healthcare Quality (CPHQ) Certified Health Data Analyst (CHDA) NCQA HEDIS Compliance Auditor (CHCAA) Project Management Professional (PMP)SALARY RANGE
$63,334 + depending on qualifications According to Executive Order No. GA-48 of the State of Texas: for all positions that research, work on, or have access to critical infrastructure as defined in Section 117.001(2), Business and Commerce Code, it is required that both candidates for employment and employees have the ability to maintain the security or integrity of the infrastructure.WORKING ENVIRONMENT/EQUIPMENT
Standard office equipment Repetitive use of a keyboard May be exposed to such occupational hazards as communicable diseases, blood borne pathogens, ionizing and non-ionizing radiation, hazardous medications and disoriented or combative patients, or others. Required Materials Resume/CV 3 work references with their contact information; at least one reference should be from a supervisor Letter of interest Employment Eligibility: Regular staff who have been employed in their current position for the last six continuous months are eligible for openings being recruited for through University-Wide or Open Recruiting, to include both promotional opportunities and lateral transfers. Staff who are promotion/transfer eligible may apply for positions without supervisor approval. Retirement Plan Eligibility: The retirement plan for this position is Teacher Retirement System of Texas (TRS), subject to the position being at least 20 hours per week and at least 135 days in length. Background Checks: A criminal history background check will be required for finalist(s) under consideration for this position. Equal Opportunity Employer: The University of Texas at Austin, as an equal opportunity/affirmative action employer,complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. The University is committed to a policy of equal opportunity for all persons and does not discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, or veteran status in employment, educational programs and activities, and admissions. Pay Transparency: The University of Texas at Austin will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. Employment Eligibility Verification: If hired, you will be required to complete the federal Employment Eligibility Verification I-9 form. You will be required to present acceptable and original documents to prove your identity and authorization to work in the United States. Documents need to be presented no later than the third day of employment. Failure to do so will result in loss of employment at the university. E-Verify: The University of Texas at Austin use E-Verify to check the work authorization of all new hires effective May 2015. The university's company ID number for purposes of E-Verify is 854197. For more information about E-Verify, please see the following: E-Verify Poster (English and Spanish) [PDF] Right to Work Poster (English) [PDF] Right to Work Poster (Spanish) [PDF] Compliance: Employees may be required to report violations of law under Title IX and the Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act (Clery Act). If this position is identified a Campus Security Authority (Clery Act), you will be notified and provided resources for reporting. Responsible employees under Title IX are defined and outlined in HOP-3031. The Clery Act requires all prospective employees be notified of the availability of the Annual Security and Fire Safety report. You may access the most recent report here or obtain a copy at University Compliance Services, 1616 Guadalupe Street, UTA 2.206, Austin, Texas 78701. #J-18808-Ljbffr University of Texas at AustinVacancy posted 2 days ago
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