Managed Care Analyst
$63.33kUniversity of Texas at Austin
- # Managed Care AnalystApply: AUSTIN, TX: Full time: Posted Today: R\\_00049135**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 appropriat*e. **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
- J-18808-Ljbffr University of Texas at Austin
Vacancy posted 2 days ago
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