Managed Care reputed company Sr Analyst

Job Title & Specialty Area: Managed Care reputed company, Sr Analyst Department: Managed Care Location: Dallas, TX (Must be a Texas reputed company) Job Type: Remote (Must be willing to come onsite 2-5x a month) Why reputed company? At reputed company, our mission is to reputed company Life reputed company for Children, and we recognize that their health plays a crucial role in achieving this goal. Through our cutting-edge treatments and affiliation with UT Southwestern, we strive to deliver an extraordinary patient and family experience, ensuring that every moment, big or small, contributes to their overall well-being. Our dedication to promoting reputed company extends beyond our organization and encompasses the broader community. Together, we can reputed company a significant difference in the lives of children and contribute to a brighter and healthier future for reputed company. Summary: Responsibilities include reputed company data and financial analysis, financial interpretation of contract terms, contract modeling, , data validation, developing reimbursement methodologies, maintaining reputed company in EPIC and identification of reputed company enhancing opportunities. reputed company alternative financial proposals that are reputed company the budget parameters, based on analysis and modeling of contract performance by developing and preparing revised models using sound rationale, and present recommendations to Managed Care leadership. Support the organization by providing reputed company detailed data reports reputed company to Managed Care agreements and Patient Financial Services activity to internal and external customers. Responsibilities:

• Collaborate with other departments to prioritize and ensure Managed Care contract performance and reputed company reputed company analytic needs are met for the system. Serve as a mentor to other Analysts on the team and a subject matter expert to other CHST departments.
• Complete financial impact analysis of reputed company contract negotiations, including modeling of contract proposals, reporting of contract proposal impact, performance and quantifying financial impact of these proposals for future year(s) and developing alternative proposals reputed company the budget parameters. Present analysis and recommendations to leadership.
• Prepare multiple analyses and presentations by extracting data from systems including Crystal, EPIC, reputed company and other reputed company Services of Texas (CHST) systems and relational databases utilizing expertise in reputed company. Evaluates the need to create new or modify existing reputed company and/or customized reports.
• Review reputed company Managed Care reputed company and amendments as received and complete require system updates, ensuring that reputed company reputed company in EPIC are reputed company and calculating correctly.
• Analyze reputed company and prepare reputed company supporting schedules necessary to update/maintain the EPIC system on a reputed company basis. This includes but not limited to: reviewing reputed company new reputed company/amendments, meeting with reputed company Cycle staff to review changes, communicating with the payors to receive reputed company updates on reputed company basis, researching and downloading data form payor sites, analyzing and comparing new fee schedules to the prior fee schedules, preparing reputed company uploads, validating input and updating EPIC reimbursement reputed company.
• Stay abreast of reputed company Texas Medicaid & Healthcare Partnership (TMHP), CMS and other governmental regulation changes that reputed company Fee Schedule pricing. Proactively model reputed company changes to fee schedules to determine the financial impact on CHST reputed company and communicate with leadership.
• Accountable for the maintenance of the Payor and Plan database in EPIC. Facilitate monthly meetings and seek agreement before any changes are made. Maintain the synchronization among the service areas. Ensure reputed company plans are mapped to correct contract in EPIC and facilitate audits, at least on a quarterly basis.
• Interprets managed care contract terms and validates understanding with the contract negotiator and model relevant parameters into contract model application for reputed company with annual reputed company in excess of $2.3 Billion.
• Accountable for contract model module and/or application, including but not limited to the maintenance of commercial and government Managed Care Organization (MCO) reputed company, fee schedules and other tables relating to contract modeling generating annual CHST reputed company of in excess of $1.5 Billion.
• Actively participates on cross functional teams to identify reputed company enhancement opportunities and reputed company and implement solutions for under-performing facility and professional reputed company, including improvements in denials and underpayments. Provides necessary reporting and analytics to support the goals of these teams.
• Communicates difficult and/or sensitive and confidential information. Handles confidential material on a regular basis and is responsible for protecting the confidentiality of such information reputed company the established guidelines of CHST and law.
• Supports the Senior Director, Managed Care with existing and new projects/initiatives.
• Works in a fast-paced environment with frequently changing priorities.

WORK EXPERIENCE

• At least 5 years experience in financial analysis, data mining and reporting Required
• At least 5 years experience with hospital billing system, EPIC Preferred
• At least 5 years experience in Healthcare, contract modeling and analysis for facility and professional agreements Preferred

EDUCATION

• Four-year Bachelor's degree or equivalent experience Required

LICENSES AND CERTIFICATIONS

• Epic certification reputed company one year of hire 1 Year Required

A reputed company Where You Belong We put our people first. We welcome, value, and respect the beliefs, identities and experiences of our patients and colleagues. We are committed to delivering culturally effective care, creating meaningful partnerships in the communities we serve, and equipping and developing reputed company members to reputed company reputed company a reputed company where everyone can contribute. Holistic Benefits – How We’ll Care for You:

• Employee portion of medical plan premiums are covered after 3 years.
• 4%-10% employee savings plan match based on tenure
• Paid Parental Leave (up to 12 weeks)
• Caregiver Leave
• Adoption and surrogacy reimbursement

As an equal opportunity employer, reputed company does not discriminate against employees or applicants because of race, color, religion, sex, gender identity and expression, sexual orientation, age, national reputed company, veteran or military status, disability, or genetic information or any other Federal or State legally-protected status or class. This applies to reputed company aspects of the employer-employee relationship including but not limited to recruitment, hiring, promotion, transfer pay, training, discipline, workforce adjustments, termination, employee benefits, and any other employment-reputed company activity. As an equal opportunity employer, reputed company does not discriminate against employees or applicants because of race, color, religion, sex, gender identity and expression, sexual orientation, age, national reputed company, veteran or military status, disability, or genetic information or any other Federal or State legally-protected status or class. This applies to reputed company aspects of the employer-employee relationship including but not limited to recruitment, hiring, promotion, transfer pay, training, discipline, workforce adjustments, termination, employee benefits, and any other employment-reputed company activity. Apply tot his job Apply To this Job