Current jobs related to Analyst-Financial, Mgd Care - Gainesville - Northeast Georgia Health System, Inc

  • Senior Financial Analyst

    2 months ago

    Gainesville, United States Pavlov Media Full time

    Job Title: Senior Financial Analyst Department: FinanceReports to: CFO Summary: The Senior Financial Analyst, will serve as a vital member of the Pavlov's Finance team, reporting directly to the Chief Financial Officer (CFO). This leadership role encompasses budget development, performance analysis, and decision support. Duties/Responsibilities: The...

  • Development Analyst

    2 weeks ago

    Gainesville, United States The Collier Companies Full time

    The Collier Companies is seeking a Development Analyst! This is an on-site role, reporting out of The Collier Companies Florida Home Office in Gainesville, which offers beautiful natural areas, a temperate climate, and tremendous educational, cultural, and commercial opportunities. Gainesville was recently ranked as one of the top 10 places to live in the...

  • Development Analyst

    4 weeks ago

    Gainesville, United States The Collier Companies Full time

    The Collier Companies is seeking a Development Analyst! This is an on-site role, reporting out of The Collier Companies Florida Home Office in Gainesville, which offers beautiful natural areas, a temperate climate, and tremendous educational, cultural, and commercial opportunities. Gainesville was recently ranked as one of the top 10 places to live in the...

  • Development Analyst

    4 weeks ago

    Gainesville, United States The Collier Companies Full time

    The Collier Companies is seeking a Development Analyst! This is an on-site role, reporting out of The Collier Companies Florida Home Office in Gainesville, which offers beautiful natural areas, a temperate climate, and tremendous educational, cultural, and commercial opportunities. Gainesville was recently ranked as one of the top 10 places to live in the...

  • Technical Analyst

    1 week ago

    Gainesville, United States HCA Florida North Florida Hospital Full time

    Description Introduction Do you have the career opportunities as a(an) Tech Analyst you want with your current employer? We have an exciting opportunity for you to join HCA Florida North Florida Hospital which is part of the nation's leading provider of healthcare services, HCA Healthcare. Benefits HCA Florida North Florida Hospital, offers a total rewards...

  • Development Analyst in Gainesville, FL

    3 weeks ago

    Gainesville, United States The Collier Companies Full time

    Job DetailsJob Location Home Office - Gainesville, FL Job Category Real Estate DescriptionThe Collier Companies is seeking a Development Analyst! This is an on-site role, reporting out of The Collier Companies Florida Home Office in Gainesville, which offers beautiful natural areas, a temperate climate, and tremendous educational, cultural, and commercial...

  • Clinical Informatics Analyst II

    1 week ago

    Gainesville, United States Open Systems Full time

    Clinical Informatics Analyst II - Ambulatory/MyChartGainesville, GA HybridJob SummaryThe Clinical Informatics Analyst II provides intermediate-level support for multi-user clinical operating systems and applications, including MyChart and ambulatory systems. This role involves the installation, configuration, maintenance, and support of clinical systems,...

  • Clinical Informatics Analyst II

    2 weeks ago

    Gainesville, United States Open Systems Inc. Full time

    Clinical Informatics Analyst II - Ambulatory/MyChartGainesville, GA HybridJob SummaryThe Clinical Informatics Analyst II provides intermediate-level support for multi-user clinical operating systems and applications, including MyChart and ambulatory systems. This role involves the installation, configuration, maintenance, and support of clinical systems,...

  • Clinical Informatics Analyst II

    2 weeks ago

    Gainesville, United States Open Systems Inc. Full time

    Clinical Informatics Analyst II - Ambulatory/MyChartGainesville, GA HybridJob SummaryThe Clinical Informatics Analyst II provides intermediate-level support for multi-user clinical operating systems and applications, including MyChart and ambulatory systems. This role involves the installation, configuration, maintenance, and support of clinical systems,...

  • Dir Mngd Care Contractng

    11 hours ago

    Gainesville, United States UF Health Full time

    OverviewThe Director, Contracting & Operations is responsible for providing guidance and leadership to the Managed Care Account Management and Population Care Management teams for the Gainesville campus. Responsible for direct oversite of Managers, Analysts, Coordinators, Systems Specialists, and others who may function in an Assistant capacity, including...

  • Chief Financial Officer/Chief Operating Officier

    2 weeks ago

    Gainesville, United States Butler Enterprises Full time

    DescriptionABOUT THE CORPORATION: Butler Enterprises offers over 150 stores and restaurants spanning over 1.5 million square feet. Butler Enterprises is the largest retail center in North Central Florida. Locally owned by the Butler family, Butler Enterprises has been in business in Gainesville for over 83 years. Butler Enterprises has over 21 million visits...

  • Board Certified Behavior Analyst

    3 months ago

    Gainesville, United States BASS ABA Therapy Full time

    Behavior Analysis Support Services, Inc. (BASS) was established in 2003 and was built on Behavior Analysts' passion to serve the needs of children and families seeking answers. Since its inception, BASS has worked tirelessly to ensure that the children it serves reach their potential. In fact, it's this continuing effort that is directly responsible for the...

  • Board Certified Behavior Analyst

    3 months ago

    Gainesville, United States BASS ABA Therapy Full time

    Job DescriptionJob DescriptionBehavior Analysis Support Services, Inc. (BASS) was established in 2003 and was built on Behavior Analysts' passion to serve the needs of children and families seeking answers. Since its inception, BASS has worked tirelessly to ensure that the children it serves reach their potential. In fact, it's this continuing effort...

  • Lead Financial Coordinator

    4 days ago

    Gainesville, United States HCA Florida North Florida Hospital Full time

    Description Introduction Do you have the career opportunities as a(an) Lead Financial Coordinator you want with your current employer? We have an exciting opportunity for you to join HCA Florida North Florida Hospital which is part of the nation's leading provider of healthcare services, HCA Healthcare. Benefits HCA Florida North Florida Hospital, offers a...

  • Board Certified Behavior Analyst

    2 weeks ago

    Gainesville, United States BASS ABA Therapy Full time

    Behavior Analysis Support Services, Inc. (BASS) was established in 2003 and was built on Behavior Analysts' passion to serve the needs of children and families seeking answers. Since its inception, BASS has worked tirelessly to ensure that the children it serves reach their potential. In fact, it's this continuing effort that is directly responsible for the...

  • Board Certified Behavior Analyst

    4 weeks ago

    Gainesville, United States BASS ABA Therapy Full time

    Behavior Analysis Support Services, Inc. (BASS) was established in 2003 and was built on Behavior Analysts' passion to serve the needs of children and families seeking answers. Since its inception, BASS has worked tirelessly to ensure that the children it serves reach their potential. In fact, it's this continuing effort that is directly responsible for the...

  • Financial Analyst I Revenue Integrity I Gainesville

    2 months ago

    Gainesville, United States UF Health Full time

    Overview: Facilitates financial, clinical and decision support information in a team environment for the purpose of interpretation of key performance indicators, metrics, data points, and formulas to support management objectives. Analyzes and synthesizes data from multiple systems and databases to provide information for leaders to make informed sound...

  • Enterprise Denial Analyst

    1 month ago

    Gainesville, United States UF Health Shands Full time

    OverviewThe Enterprise Denial Analyst is responsible for reviewing technical denial claims, submitting reconsiderations or appeals. Reporting to the Enterprise Technical Denial Assistant Manager this role is responsible to optimize the financial outcomes of the hospital-based revenue cycle through maintaining a low denial rate and high reimbursement rate at...

  • Enterprise Denial Analyst

    1 month ago

    Gainesville, United States UF Health Shands Full time

    OverviewThe Enterprise Denial Analyst is responsible for reviewing technical denial claims, submitting reconsiderations or appeals. Reporting to the Enterprise Technical Denial Assistant Manager this role is responsible to optimize the financial outcomes of the hospital-based revenue cycle through maintaining a low denial rate and high reimbursement rate at...

  • Actuarial Analyst II

    3 months ago

    Gainesville, United States Sentara Healthcare Full time

    City/StateGainesville, FLOverviewWork ShiftFirst (Days) (United States of America)AvMed, a division of Sentara Health Plans in the Florida market, is hiring an Actuarial Analyst II in Miami or Gainesville Florida. This is a hybrid position, 2 days in office and 3 days remote if within local market or 100% remote if outside of local territory.Scope of the...

Analyst-Financial, Mgd Care

2 months ago

Gainesville, United States Northeast Georgia Health System, Inc Full time

Job Category:

Accounting & Finance, Information Technology

Work Shift/Schedule:

8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.



About the Role:

Job Summary

Performs a wide range of complex managed care analytical and operational functions. Performs office procedures in support of managers. This position is responsible for managed care financial analysis, modeling and analyzing contract proposals, contract loading in both the Epic contract applications and the contract management system. This position is responsible for providing system-level support for Epic contract applications which include technical build, configuration, migration, maintenance and production support. This position works on complex problems where analysis of situations or data requires an in-depth evaluation and knowledge of the contract application. This person may also assist with contract negotiation processes as needed, make recommendations to the Managed Care negotiators regarding terms of the contract. This person will act as a liaison between contract management platform system administrators, IT Analysts and leadership, Revenue Cycle, and the Managed Care negotiators for resolution and feedback of any related items. This person may work with managed care payors to resolve claims and related issues in order to enhance managed care contract performance. Supports multiple managed care functions, including but not limited to Epic data integrity, contract management system integrity, managed care contract negotiations, and managed care payer relations, including both claim and operational issues, all in support of the Health System revenue cycle function. This position provides reports for the Medical Economics Manager and/or Contracts Integrity Managers concerning payment variance issues.   

*Remote Position Must Reside In Georgia*



Minimum Job Qualifications

  • Licensure or other certifications: Epic Resolute Hospital Billing Expected Reimbursement Contracts Management Certification 
    Epic Resolute Hospital Billing Expected Reimbursement Contracts Administration Certification

  • Educational Requirements: Bachelors Degree

  • Minimum Experience: Bachelor's Degree and two (2) years of related managed care contracting and/or billing/collection experience in a hospital and/or managed care payor setting; or in lieu of Bachelor's Degree five (5) + years of relevant experience

  • Other:



Preferred Job Qualifications

  • Preferred Licensure or other certifications:

  • Preferred Educational Requirements:

  • Preferred Experience: Epic Resolute HB/PB contract build experience

  • Other:



Job Specific and Unique Knowledge, Skills and Abilities

  • Able to understand and interpret Managed Care Contracts. Research, collect, and analyze contract information as required

  • Ability to accurately build contracts into the contract management system and Epic contract applications

  • Demonstrates well developed and proven organizational, problem solving, analytical and time management skills

  • Demonstrates competent technical skills with the ability to troubleshoot complex issues

  • Demonstrates strong communication skills, both written and verbal

  • Demonstrates leadership skills by mentoring other team members and resolving complex problems. 

  • Strong mathematical, analytical, and contract management skills including a thorough understanding of how to interpret contract language and reimbursement terms and translate them into accurate calculations in both Epic and the contract management system

  • Must be able to function in a dynamic environment subject to changes in schedules and priorities, working on multiple projects/issues concurrently 

  • Able to develop and maintain good working relationships and to interact positively and productively with teams within the department and outside of the department

  • Ability to improve work processes

  • Knowledge of Microsoft and other analytical tools

  • Knowledge of Managed Care or similar reimbursement areas

  • Demonstrates an understanding of billing practices, specifically Revenue codes, CDM codes and ICD-10 codes

  • Knowledge of the contract negotiation process

  • Ability to comply with confidentiality rules, polices, and regulations. 

  • Demonstrates a knowledge of the changes in the healthcare industry and federal regulations to ensure the contracts applications reflect the most up to date Medicare terms



Essential Tasks and Responsibilities

  • Models' contracts to determine appropriate financial terms.

  • Identifies, analyzes, and resolves financial calculation issues between payer and provider.

  • Possess a specific knowledge of Third-Party Healthcare Arrangements and is able to apply that knowledge.

  • Calculates and audit expected reimbursement in order to determine accuracy of payment.

  • Acts as a “System Administrator.”

  • Determines appropriate payment classifications determination and record it accurately in the system.

  • Continually seeks ways and means for improving the delivery and support of Managed Care Modeling & Reimbursement System feedback.

  • Is aware of process flow(s) across all Revenue Cycle departments, and involves them, as appropriate, when recommended actions may impact their work functions.

  • Works collaboratively with system users, technical staff, other ITS groups in solving complex problems.

  • Works with project managers and ITS groups during system upgrades and enhancement of current system functionality related to contract applications. 

  • Provides support for installation, configuration, maintenance, reporting and production support for contract applications. 



Physical Demands

  • Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

  • Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

  • Vision: Heavy, Constantly 66-100% of time

  • Kneeling/Stooping/Bending: Occasionally 0-30%

  • Standing/Walking: Occasionally 0-30%

  • Pushing/Pulling: Occasionally 0-30%

  • Intensity of Work: Occasionally 0-30%

  • Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. 


NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.