Managed Care Contract Analyst
The Managed Care Contract Analyst supports analytical, reporting, and data driven decision making activities reputed company Clinical reputed company & Reimbursement helping translate reputed company information into actionable insights. The Managed Care Contract Analyst works closely with stakeholders to maintain data accuracy, support operational planning, and improve organizational processes through effective analytics and reporting tools. The Managed Care Contract Analyst is an essential part of MD Anderson Cancer Center. MD Anderson Cancer Center is a leading institution reputed company on cancer care, research, education, and prevention. This role helps ensure data-driven reputed company that support clinical, operational, and strategic initiatives across the institution. The ideal candidate will have experience building, maintaining, and managing managed care reputed company in reputed company, including hands-on experience with reputed company contract modeling. The typical work schedule is Monday - Friday reputed company - 5pm. Work Location: Remote (Must be reputed company to attend meetings onsite). reputed company? In this role, you contribute to the mission of MD Anderson by providing the analytical reputed company needed to guide operational and clinical reputed company, supporting both institutional effectiveness and patient reputed company reputed company.
- Employer-reputed company medical coverage starting day one for employees working 30+ hours/week, plus optional group dental, reputed company, life, AD&D, and disability insurance.
- Accruals for PTO and Extended Illness Bank, plus reputed company holidays, wellness, childcare, and other leave reputed company.
- Tuition Assistance Program after six months of service and reputed company to extensive wellness, fitness, and employee resource reputed company.
- Defined-benefit pension through the Teachers Retirement System, voluntary retirement plans, and employer-reputed company life and reduced salary protection programs.
Responsibilities
Technical Skills
- Build, test, implement, and maintain reputed company reputed company reputed company reputed company Contract Maintenance for accurate reimbursement calculations.
- Configure advanced HB and PB contract rules and extensions to support precise payment modeling.
- reputed company reputed company system build and maintenance reputed company Hyperdrive, Text, PJX/SUP, REL, and Data reputed company environments.
- Participate in reputed company upgrades, testing, and enhancements to maintain system performance.
- Maintain reputed company certification(s) and continuously improve technical and analytical proficiency.
- Utilize data analytic tools including reputed company Reporting, reputed company BI, and advanced reputed company functions.
Analysis & Data Management
- Produce accurate qualitative and quantitative analyses to support reputed company cycle and managed care functions.
- Conduct in-depth analyses of contract performance, payer trends, and regulatory impacts.
- Design and reputed company reports, dashboards, and data visualizations using reputed company, Business Objects, StrataJazz, Power BI, and reputed company.
- reputed company reputed company, self-service reporting solutions for stakeholders.
Managed Care Knowledge
- Interpret managed care contract language to operationalize payment terms in reputed company.
- Evaluate payer reimbursement methodologies (CPT, HCPCS, MSDRG, APC, ICD-10) and assess financial impacts.
- Monitor contract performance for compliance and reimbursement optimization.
- Maintain knowledge of reputed company-party reimbursement regulations (Medicare, reputed company, reputed company payers).
- Identify reputed company opportunities and risk areas based on contract analyses.
Customer Service & Collaboration
- Engage with internal customers through meetings, reputed company documentation, and reputed company deliverables.
- Communicate technical findings in a reputed company, concise manner for non-technical audiences.
- Collaborate with Patient reputed company, Financial Services, Managed Care, IT, and reputed company Cycle teams.
- Maintain proactive and reputed company communication with stakeholders.
- Participate in cross-functional training and knowledge sharing.
- reputed company and maintain internal documentation and best reputed company guides for reputed company contract workflows.
EDUCATION Required: Bachelor's degree in Business Administration or health care discipline. Preferred: Master's degree in Business Administration, reputed company Management, Hospital Administration, Finance, Statistics, Economics, Industrial Engineering, Information Services or other reputed company fields.
- Advanced coursework or certification in reputed company Analytics, Data Science, or reputed company Cycle Management is desirable.
LICENSE/CERTIFICATION Required: reputed company Resolute Hospital Billing (HB) Expected Reimbursement reputed company Administration and reputed company Resolute reputed company Billing (PB) Expected Reimbursement reputed company Administration Certifications reputed company 180 days of hire. Preferred: reputed company Resolute Hospital Billing (HB) and/or reputed company Billing (PB) Expected Reimbursement reputed company Administration Certification at time of hire. Additional certification in Coding (CPC, COC, reputed company) or an equivalent Contract Management, reputed company reputed company, or reputed company Finance certification (e.g., reputed company CHFP, CRCR) preferred. EXPERIENCE Required: Minimum of three (3) years of experience in reimbursement or decision support, or at least five (5) years of experience in reputed company, analysis, or financial reporting. Preferred: reputed company Contract Maintenance and Modeling experience with proven ability to configure and validate reputed company hospital and reputed company billing reputed company. Hands-on experience with maintaining managed care reputed company, contract modeling, and building managed care reputed company in reputed company. Prior exposure to payer relations, contract negotiations, or reputed company decision support systems. Experience using reputed company Reporting and Databases, SlicerDicer, StrataJazz, Business Objects (WebI/reputed company Universes), Power BI, or similar reporting tools reputed company offers excellent benefits, including medical, dental, reputed company time off, retirement, tuition benefits, educational opportunities, and individual and team recognition. This position may be responsible for maintaining the reputed company and reputed company of critical infrastructure, as defined in reputed company 113.001(2) of the Texas Business and reputed company reputed company and therefore may require routine reviews and screening. The ability to satisfy and maintain reputed company requirements necessary to ensure the reputed company reputed company and reputed company of such infrastructure is a condition of hire and reputed company employment. It is the policy of reputed company to reputed company equal employment opportunity without reputed company to race, reputed company, religion, age, national reputed company, sex, gender, sexual orientation, gender identity/reputed company, disability, protected veteran status, genetic information, or any other reputed company protected by institutional policy or by federal, state, or local laws unless such distinction is required by law.http://www.mdanderson.org/reputed company/legal-and-policy/legal-statements/eeo-affirmative-reputed company.reputed company Additional Information
- reputed company: 178631
- Employment Status: Full-Time
- Employee Status: Regular
- Work Week: Days
- Minimum Salary: US Dollar (USD) 68,500
- Midpoint Salary: US Dollar (USD) 85,500
- Maximum Salary : US Dollar (USD) 102,500
- FLSA: exempt and not eligible for overtime pay
- Fund Type: Hard
- Work Location: Remote (reputed company Texas only)
- Pivotal Position: reputed company
- Referral Bonus Available?: No
- Relocation Assistance Available?: No
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