Managed Care Contract Analyst

3 weeks ago

Alhambra, United States CareerBuilder Full time

Overview:
Position Summary:
Uses industry experience and knowledge to develop pricing models for proposals. Serves as the SME for the Corporate Managed Care Contracting department. Provides consultation, analysis, and guidance to create pricing solutions to maximize profit. Supports and validates hospital contracting activities through financial and network pricing modeling, analysis, and reporting. Conducts contract valuation analysis in support of contract negotiations and revenue enhancement or cost management strategies.

Responsibilities:
Key Responsibilities include:
With limited guidance, develops pricing models for proposals within the company for multiple types of contracts (health plan, hospital, ancillary services, etc.).
Analyze data from multiple sources and integrate into interactive pricing models including but not limited to financial and claims data.
Provides consultation, analysis, and guidance to create pricing solutions to maximize profit.
Assist with building, testing, and maintenance of various monitoring dashboards.
Proactively identify issues and inconsistencies as well as potential risk and pulls ideas, issues, observations, and recommendations into clear and concise presentation to internal clients.
Works with contract leads to identify revenue optimization or unit cost savings opportunities as applicable.
Assists in the design, development, and implementation of advanced ad hoc reports.
Assists in identifying and documenting reporting requirements, extracting and manipulating data from databases, and performing acceptance and QA testing as applicable.
Ability to work both independently and within Managed Care Contracting team on projects and collaborate with multiple departments across the organization to gather data and provide meaningful reports.

Qualifications:
Qualifications:
Bachelor's degree or equivalent education and experience in business, finance, economics, mathematics, or related field required.
Must be PC proficient.
Must have strong experience with MS Office tools; and be capable of learning web-based modeling applications.

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