Surgical Care Affiliates

Managed Care Analyst

US-CA-Pasadena
Type
Full-Time
# of Openings
1

Overview

Surgical Care Affiliates owns and/or provides management services to over 200 ambulatory surgery centers, surgical hospitals, and hospital surgery departments, in partnership with approximately 2,800 physicians and in affiliation with 105 health systems. SCA's clinical systems, service line growth strategies, benchmarking processes, and efficiency programs create measurable advantage for surgical facilities – clinically, operationally, and financially. 

Accountabilities / Responsibilities

The fundamental objective of the Analyst of Managed Care is to support the Director of Payer Analytics in effectively analyzing managed care contracts.   The position will require an understanding of government payers and other commercial/managed care/IPA carrier processes including capitation.  The Managed Care Analyst conducts financial analysis for managed care negotiations and performs subsequent analysis and reporting of net revenue. The individual will be required to manage multiple projects and timelines.

  • Interpret data accurately and produce clear and comprehensive written analyses, graphics, tables, and presentations for diverse internal and external audiences
  • Conducts ongoing analysis of contract compliance and financial performance for third-party payers to provide leadership with support during payer contract negotiations
  • Analyze payment data to ensure accurate and adequate payment
  • Research managed care contracts and payers for negotiation purposes
  • Assist Contractors in reviewing contract language and validate contract loading
  • Assists in establishing financial impact reports and rate comparisons
  • Aids in the roll out and communication process of new contracts
  • Creates tracking tools that aid in renewals, decision making and standardization  
  • Conducts ongoing analysis of contract compliance and financial performance for third-party payers to provide leadership with support during payer contract negotiations
  • Helps design and implement improvements to established or proposed reimbursement process flows in an effort to maximize potential revenue
  • Stays apprised of current industry regulatory changes, best practices and aligns departmental processes with applicable practices as needed

Qualifications

  • Bachelor’s Degree in Business, Accounting, Finance, statistics or mathematics
  • Experience analyzing data/producing reports and working with large data sets
  • Preferred experience in revenue cycle management and managed care contracting related fields
  • Highly proficient in Excel; familiarity/experience in SQL and Access, Microsoft Reporting Services, OLAP reporting, data cubes, and web based reporting/deployment a plus.
  • Ability to research and analyze financial and operational information
  • Ability to structure queries to pull data from data warehouse
  • Knowledge of third-party payer regulations, reimbursement, and payment policies
  • Understanding of medical terminology and medical record coding
  • Strong interpersonal skills and the ability to work collaboratively
  • Proficiency in utilizing Microsoft Excel and other database management software

Please click here to apply:http://bit.ly/2AkHkFC

2017-3822

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