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Managed Care Analyst - Modeler

Charlotte, NC, United States
Job ID: 8841
Job Family: Financial Services
Status: Full Time
Shift: Day
Shift Details: Regular
Department Name: 51011028341157-Contract Modeling and Support
Location: Atrium Corporate Operations

Overview

Job Summary

Responsible to managed care reimbursement schemes for net revenue, contractual discount and contribution and net margins. Models the impact of proposed reimbursement schemes for facility, physician and ancillary managed care contracts and monitors actual results against the modeled projections. Ideal candidates must have very strong excel experience.

Essential Functions

  • Models and analyzes proposed managed care reimbursement schemes for net revenue, contractual discount and contribution, and net margins.
  • Comprises hospitals, physicians, ancillary and free standing outpatient centers for owned, leased, managed and affiliated providers.
  • Develops objectives for reimbursement scenarios with the contract negotiating team, then provides timely written and verbal communication of the results.
  • Develops, designs and executes analyses to profile the financial performance of specific payors against other payors and against the portfolio average to assist in the strategy development for contract negotiations.
  • Provides consultation to the contract negotiating team on the key reimbursement drivers for each model to assist them in their responses during the negotiation process.
  • Provides input to the developers on functional design, data components and other parameters that impact the efficiency and accuracy of the modeling tools.
  • Performs routine and regular analysis of the contracts' performance in comparison to the modeled results; details and communicates the key drivers of any variance detected.
  • Assists team members in codifying the final contract terms into the contract management system.

     

Physical Requirements

 

Performs most work under normal office conditions; may include sitting for long periods of time, standing, walking, climbing stairs, using repetitive wrist/arm motion of lifting articles up to twenty-five pounds.



Education, Experience and Certifications

Bachelor's Degree is required, MBA or MHA preferred. Minimum of two years in provider managed care is preferred but will consider candidates with three or more years experience in managed care payor or hospital decision support. Advanced skills in MS Excel and Access are required.