Senior Managed Care Analyst - Southwestern Health Resources

Senior Managed Care Analyst - Southwestern Health Resources

Southwestern Health Resources is looking for a highly skilled Payor Analyst .

Is that you?

Work Location: Remote: Southwestern Health Resources Headquarters, Hybrid: 1601 Lyndon B.

Johnson Freeway, Farmers Branch, TX 75234.

Work Hours: Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion)

1 day a week onsite required

Department Highlights:


* Remote Position


* Gain a sense of accomplishment by contributing to a teamwork environment.


* Receive excellent mentorship, comprehensive training, and dedicated leadership resources.


* Contribute and work on a cross functional team

What You Will Do:

Analyze hospital and ASC claims, payments, contractual allowances, and reimbursement trends to evaluate payer performance.

30%
Support continuous improvement of operational efficiencies of the agreements during the term of the contracts by monitoring and comparing estimated reimbursement to actual payments.

Work with CBO on payment issues and attend JOC meetings.

15%
Produce recurring and ad hoc financial reports, dashboards, and executive summaries supporting contract negotiations and operational decision-making.

10%
Provide analysis and recommendations around service line pricing and margins using market research.

10%
Assist Managed Care Contracting during contract negotiations by providing analytics in support of strategic payor initiatives.

10%
Participate in special projects involving reimbursement optimization, contract implementation, and financial performance improvement.

15%
Coordinate the loading and accuracy of facility and physician managed care contracts with SaaS vendor
10%

What You Need:

Education
Bachelor's Degree Business or related field Req

Experience
5 Years Decision support or financial analysis within the healthcare industry, including contract reimbursement modeling.

Req
3 Years Experience in a managed care team that utilzes contract modeling platforms such as PMMC Contract Pro, Strata, or similar healthcare reimbursement software.
Pref

Skills
Intermediate SQL experience, including writing queries, joins, and aggregations.
Strong Microsoft Excel skills, including advanced formulas, and PivotTables.
Excellent written and verbal communication skills with the ability to present complex financial information to both technical and non-technical audiences.
Experience with business intelligence tools such as Power BI or Tableau.

Supervision
Individual Contributor

ADA Requirements
Working Indoors 67% or more

Physical Demands
Sedentary