Sr. Managed Care Analyst

Full-time

Community Health System

Fresno, CA

Job Description

Overview

Opportunities for you!

Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek

Eligible for annual incentive program

Community University leadership training courses

Tuition reimbursement, education programs and scholarships

Vacation time starts building on Day 1, and builds with your seniority

Free money toward retirement with a 403(b) and matching contributions

Free parking and electric charging

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.

Responsibilities

The 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

Apply

Vacancy posted 25 days ago

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