Contract Analyst Managed Care

2 weeks ago


Janesville, United States Mercy Health System Full time

JOB REQUIREMENTS: Overview Managed Care Contract Analyst, Days, 80 Hrs / 2 wks Location: Mercycare Bldg, Janesville, WI OR Rockton Ave Campus, Rockford, IL. Hybrid, flexible work schedule, and remote opportunities available. Mercyhealth does not currently support remote workers with residency in the following states: CA, OH, OR, PA, NJ, NY. Under the direction of the Managed Care Director and Managed Care Manager the Managed Care Contracting Analyst will support Managed Care contracting, and maintain the development of standard and sustainable contract build, contract modeling, training, and project management related to root cause mitiation. The Managed Care Contracting Analyst is responsible for providing support to the Managed Care Contracting team, providing training to new Managed Care Contracting partners as well as ongoing training to existing Managed Care Contracting partners, and for the performance of analytic functions within the managed care contracting process, including comprehensive data analysis, financial and operational projects. Additionally, this position is responsible for building and the maintenance of managed care contractual terms within the Epic system.The Analyst will monitor the use of the Epic contracts at a high level to determine if the Payor contracts are built efficiently and on time. Responsibilities Provides contracting support for Mercyhealth managed care contracting initiatives, to include review of all contract and amendment proposals. Assists with providing oversight for all managed care contractual terms building, testing, and production within Epic or other ancillary systems. Provides support for contract negotiations, including measurement of results. Serves as subject matter expert with regards to Mercyhealth managed care contracts. Works corroboratively with system-wide personnel in the implementation of system managed care agreements. These duties may include but are not limited to identifying training needs, reporting needs, and the ongoing management and administration of agreements. Builds and maintains all current and updated managed care contractual terms within Epic; tests all ongoing models to assure contract payment accuracy and integrity. Monitors creation and completion mapping for all new payer/plans for Mercyhealth in Epic. Interfaces with other Revenue Cycle areas to identify and resolve issues. Provides recommendations for Epic contract maintenance and the development of new tools to support contracts and model build. Collaborates with all Revenue Cycle and other areas on researching and resolving contract variances and discrepancies. Works the various underpayment and overpayment work queues, and submits reconsiderations and/or appeals as necessary. Consults as needed with clinical and operational teams on managed care... For full info follow application link. EOE&AA/M/F/Vet/Disabled. Mercy is an equal employment opportunity employer functioning under Affirmative Action Plans. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/F17DABD0DE3444A2



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