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Managed Care Analyst, UT Health Austin, Dell Medical School
3 months ago
Job Posting Title:
Managed Care Analyst, UT Health Austin, Dell Medical School----
Hiring Department:
Dell Medical School----
Position Open To:
All Applicants----
Weekly Scheduled Hours:
40----
FLSA Status:
Exempt----
Earliest Start Date:
Immediately----
Position Duration:
Expected to Continue----
Location:
UT MAIN CAMPUS----
Job Details:
General Notes
This role will define and develop processes to collect, distill and interpret data with a goal to aid better, more informed decision making. The Managed Care Analyst will also examine and explore data from multiple disparate sources including Electronic Medical Record (EMR) systems, with the goal of discovering insights related to, fee for-service and value-based contracting and payments, business case development and revenue cycle key performance metrics. Additionally, this role will translate analytic findings into business solutions that provide impact and align with the mission and vision of the organization.
Purpose
The purpose of this position is to capture, transform, interpret, and present healthcare data, in support of the best possible decision making and outcomes on a variety of strategic initiatives. They will lead payer contracting analytics, payment modeling and reporting, and analytics of revenue cycle key performance indicators (KPIs) in support of successful contract negotiations and payer performance monitoring.
Responsibilities
Leads modeling of commercial and government payment methodologies for all types of healthcare services: physician, ambulatory and hospital etc.
Transforms data into analytical insights, to inform decisions for the Managed Care, Revenue Cycle and Executive stakeholders.
Effectively communicates analysis to be consumed by department and executive leadership.
Demonstrates expert knowledge of both commercial and governmental payers for modeling and analyzing contract proposals with a variety of reimbursement methodologies: fee schedules, case rates, DRG, stop loss and other contract terms.
Leverages physician (such as Experian MPV) and hospital (such as FinThrive) claim modeling systems for enhanced payer contract analytics.
Continuously learns and adapts to a constantly changing reimbursement environment.
Completes extensive and complex financial and operational analyses, modeling of managed care contracts and proposals, analyze fee schedules, revenue cycle KPIs, and determine contract performance and compliance.
Performs analysis of claims data files to identify global denial and payment (over/underpayment) trends with payers
Extracts, analyzes, and synthesizes data from various sources to identify risks and opportunities.
Maximize the use of EMR reporting capabilities related to managed care and revenue cycle to inform and enhance decision making.
Represent department needs as it relates to EMR system maintenance and upgrades.
Additional Duties as assigned.
Bachelor's degree in Data Science, Analytics, Economics, Finance, Statistics, Mathematics, Actuarial Sciences or other quantitative discipline. At least five years, related work experience demonstrating increasing responsibility. Advanced knowledge of commercial and government reimbursement, managed care contracting, fee schedules, revenue cycle management and EMR software systems such as Athena and Epic. Experience with advanced analytics, strong attention to detail, likes to solve problems, and is intellectually curious and an innovator. Excellent oral and written communication skills. Ability to communicate well, present ideas and solution to executives and coherently discuss complex topics with both technical and business audiences. Highly competent with quantitative data analysis and utilizing data to drive decision-making, specifically related to financial analysis and data support to determine the financial viability and efficacy of proposed managed care contracts. Ability to tell a story with data both verbally and visually. Have an open mind to pick up new analytical techniques as required. Demonstrate expert skills in analytical and statistical techniques and approaches used to drive fact-based decision-making. Successful partnering experience with technology departments, EMR vendors, claim modeling vendors, data integration and decision science-based resources to solve complex business problems. Provides subject matter expertise in operationalizing recommendations.
Relevant education and experience may be substituted as appropriate.
Preferred QualificationsMaster's degree in Data Science, Analytics, Economics, Finance, Statistics, Mathematics, Actuarial Sciences or other quantitative discipline. Advanced Microsoft Excel Skills Two (2) or more years of experience using Tableau or similar BI tools to build reporting dashboards and analyze data. Experience with financial/business operations reporting in Healthcare. Experience with health data analytics as it relates to managed care contracting and revenue cycle. Application of data privacy practices and laws to ensure privacy, security, and confidentiality, including HIPAA. Proficient skills with modeling and forecasting beyond simple regression.
Salary Range$65,000 + depending on qualifications
Required Materials-
Resume/CV
- 3 work references with their contact information; at least one reference should be from a supervisor
- Letter of interest
Importantfor applicants who are NOT current university employees or contingent workers:You will be prompted to submit your resume the first time you apply, then you will be provided an option to upload a new Resume for subsequent applications. Any additional Required Materials (letter of interest, references, etc.) will be uploaded in the Application Questions section; you will be able to multi-select additional files. Before submitting your online job application, ensure thatALLRequired Materials have been uploaded. Once your job application has been submitted, you cannot make changes.
Important for Current university employees and contingent workers:As a current university employee or contingent worker, you MUST apply within Workday by searching for Find UT Jobs. If you are a current University employee, log-in to Workday, navigate to your Worker Profile, click the Career link in the left hand navigation menu and then update the sections in your Professional Profile before you apply. This information will be pulled in to your application. The application is one page and you will be prompted to upload your resume. In addition, you must respond to the application questionspresented to upload any additional Required Materials (letter of interest, references, etc.) that were noted above.
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Employment Eligibility:
Regular staff who have been employed in their current position for the last six continuous months are eligible for openings being recruited for through University-Wide or Open Recruiting, to include both promotional opportunities and lateral transfers. Staff who are promotion/transfer eligible may apply for positions without supervisor approval.----
Retirement Plan Eligibility:
The retirement plan for this position is Teacher Retirement System of Texas (TRS), subject to the position being at least 20 hours per week and at least 135 days in length.----
Background Checks:
A criminal history background check will be required for finalist(s) under consideration for this position.
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Equal Opportunity Employer:
The University of Texas at Austin, as an equal opportunity/affirmative action employer,complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. The University is committed to a policy of equal opportunity for all persons and does not discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, or veteran status in employment, educational programs and activities, and admissions.
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Pay Transparency:
The University of Texas at Austin will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
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Employment Eligibility Verification:
If hired, you will be required to complete the federal Employment Eligibility Verification I-9 form. You will be required to present acceptable and original documents to prove your identity and authorization to work in the United States. Documents need to be presented no later than the third day of employment. Failure to do so will result in loss of employment at the university.
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E-Verify:
The University of Texas at Austin use E-Verify to check the work authorization of all new hires effective May 2015. The university's company ID number for purposes of E-Verify is 854197. For more information about E-Verify, please see the following:
- E-Verify Poster (English) [PDF]
- E-Verify Poster (Spanish) [PDF]
- Right To Work Poster (English) [PDF]
- Right To Work Poster (Spanish) [PDF]
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Compliance:
Employees may be required to report violations of law under Title IX and the Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act (Clery Act). If this position is identified a Campus Security Authority (Clery Act), you will be notified and provided resources for reporting. Responsible employees under Title IX are defined and outlined in HOP-3031.
The Clery Act requires all prospective employees be notified of the availability of the Annual Security and Fire Safety report. You may access the most recent report here or obtain a copy at University Compliance Services, 1616 Guadalupe Street, UTA 2.206, Austin, Texas 78701.
