Managed Care Analyst
3 weeks ago
Job Summary
Under general supervision of the Vice President of Managed Care, the Senior Managed Care Analyst develops, directs and/or performs analytical and planning functions in support of managed care decision making. Proactively identifies areas of opportunity with regard to reimbursement for the hospital and practitioners. Integrally involved in Managed Care contract functions including analysis of contract language and rate structure, and maintenance of contractual agreements that require updating through system programming. Responsible for internal distribution of data and provides other support as needed in the Managed Care department. Interacts interdepartmentally on operational issues associated with rate implementation and payment variances. Maintains knowledge and understanding of the current developments in the healthcare industry to include: service delivery, reimbursements, compliance/regulations, policies and procedures of Governmental and Commercial payers. Responsible for performing job duties in accordance with mission, vision and values of Tampa General Hospital.
* High School Diploma or GED with a minimum of 10 years of relevant experience or Bachelor's Degree in Related Field with a minimum of 5 years of relevant experience. An equivalent combination of education and years of experience may be considered.
* Superior Microsoft Excel, Word and Access skills.
* Strong analytical, problem solving, and communication skills.
* Knowledge of advanced analytical techniques.
* Ability to work independently and bring projects to conclusion.
* Strong working knowledge of physician and hospital services billing, financial analysis, contracting methods, and contract interpretation.
* Ability to maintain a high level of accuracy when reviewing data and performing tasks.
* Detail-oriented with the ability to handle multiple competing priorities.
* Exceptional organizational skills required and ability to learn new systems.
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