Managed Care Analyst

3 days ago

Fountain Valley, United States MemorialCare Full time

Title: Managed Care Analyst

Location: Fountain Valley

Department: Accounts Payable

Status: Full-time/Hybrid (Thursdays in office)

Shift: Days (8hr shift)

Pay Range: $34.43/hr - $49.96/hr

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Purpose Statement / Position Summary

The Managed Care Analyst (MCA) supports the leadership by preparing reports and basic analysis from internal data sources. Key traits of this position are: strong analytical skills, highly motivated, and able to utilize conventional and unconventional methods to solve problems and take ownership of issues.

Essential Functions and Responsibilities of the Job

  1. Depending on reporting area(s) assigned, some or all of the following:
  2. Populate pre-defined templates with health plan data for analysis by senior team members.
  3. Participate in financial statement audit by providing requested reports and answering inquiries.
  4. Complete and distribute monthly reporting packages for JOCs.
  5. Assist and collaborate with senior team members and other departments to design and run queries and reports based on external reporting requests, ensuring data integrity and timeliness.
  6. Provide data support to other departments to support various modeling.
  7. Responsible for encounter processing.
  8. Provide analysis of medical expense fluctuations to leadership.
  9. Ad hoc reporting and analysis, as needed.
  10. Be at work and be on time.
  11. Follow company policies, procedures, and directives.
  12. Interact in a positive and constructive manner.
  13. Prioritize and multi-task.

Essential Job Outcomes

  1. Pre-defined templates are populated with health plan data for analysis by senior team members. Ensures data integrity, identifies potential anomalies, and collaborates with senior team members regarding appropriate follow-up. Ensures timely completion of such templates. All completed with some direction from supervisor.
  2. Promptly responds to financial statement audit requests. Inquiries are addressed quickly, completely, and accurately with some direction from supervisor.
  3. Monthly JOUM packets are prepared accurately and include some analysis of fluctuations. Completed in accordance with established deadlines and some direction from supervisor.
  4. Responsible for encounter processing.
  5. Collaborations with senior team members and other departments to design and run queries and reports are productive and achieve desired results.
  6. Analysis of medical expense fluctuations is thorough, accurate and meets established deadlines with some direction from supervisor.
  7. Ad hoc reports/requests are completed accurately, timely, and meet established expectations with some direction from supervisor.
  8. 'Other duties as assigned.'

Experience

  1. Proficient in Access and Excel, as well as other MS Office products.
  2. Minimum 3 years' experience, preferably in healthcare or managed care.
  3. Extremely organized with strong sense of priority, urgency, and commitment to deadlines.
  4. Self-motivated individual able to handle fluctuating volumes of work, able to prioritize to meet deadlines.

Education

  1. Bachelor's degree required.
  2. Training in Excel required.
  3. Training in RDBs, Sequel preferred.

Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family.

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