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[Hiring] Sr. Managed Care Contract Analyst @Emerus

Work from home Full-time role Hiring

Role Description This role collaborates closely with the Vice President of Managed Care to support the company and its joint venture hospital partners. Key responsibilities include:

  • Managing contract databases
  • Interpreting critical contract terms
  • Developing and automating payer contract models
  • Validating data
  • Conducting financial analysis
  • Ensuring federal price transparency compliance
  • Contributing to annual budgeting and month-end close processes
  • Providing support to Revenue Cycle and Revenue Recognition teams on payer-related issues and contract disputes
  • Assisting other departments as needed The ideal candidate is a proactive self-starter who thrives in a dynamic, fast-paced environment. They possess strong analytical and modeling skills, excellent communication and listening abilities, and a keen intellectual curiosity to identify opportunities for improving departmental efficiency and enhancing company revenue.

Qualifications

  • Bachelor’s degree in Finance, Accounting, Business Administration, or equivalent experience required
  • Minimum of 3 years of healthcare experience preferred, with deep knowledge of hospital payment methodologies and health plan contracting processes
  • Proven ability to build financial and statistical models, analyze data, and drive actionable results
  • Excellent organizational, written, and verbal communication skills
  • Advanced Microsoft Excel modeling skills (required); proficiency in Word, PowerPoint, and Outlook (essential)
  • Ability to write efficient queries for data retrieval, filtering, and manipulation using SQL
  • Intermediate knowledge of data preparation and visualization techniques using PowerBI
  • Strong analytical and problem-solving capabilities
  • Comfortable working in a fast-paced environment with minimal supervision
  • Ability to meet deadlines while managing multiple projects and delivering high-quality work
  • Detail-oriented with a strategic, big-picture mindset Requirements
  • Serve as the managed care liaison and subject matter expert for joint venture hospital partners, revenue cycle billing and collections teams, and finance department leaders
  • Compile and analyze payer performance metrics for reporting to organizational leadership
  • Maintain up-to-date managed care contract databases to streamline collections, support analysis, and share contract terms efficiently
  • Assist the revenue cycle team by loading and maintaining current payer rates in an insured allowed/payment validation module
  • Perform random audits of claim payments to ensure payer compliance with managed care agreements
  • Support special projects, including claim data analysis for contract negotiations, service line research, and pro formas for new market opportunities
  • Build contract models to assess current performance yields and evaluate new contract proposals
  • Collaborate with the revenue cycle team to identify underpaid/overpaid claims and develop initiatives to secure accurate payments
  • Provide managed care insights and contract modeling (e.g., rate escalators, charge master updates, new contract yields) to support the finance team’s annual budget process
  • Assist the revenue recognition team during month-end close by offering managed care perspectives on key revenue-influencing items
  • Ensure compliance with federal and state price transparency regulations by preparing and maintaining required files
  • Represent managed care in joint venture board meetings or monthly operational reviews as required
  • Conduct financial data analysis and respond to internal/external inquiries from management Benefits
  • Provide clear explanations and actionable recommendations on managed care topics
  • Contribute to cross-functional projects with Finance, Operations, Revenue Cycle, and Business Development, delivering ad-hoc analysis as needed
  • Attend required staff meetings, company-sponsored events, or mandated gatherings
  • Take ownership of personal professional development
  • Perform additional duties as assigned Apply tot his job

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