Senior Operations Analyst Managed Care

2 days ago


Lake Forest, Illinois, United States Northwestern Memorial Healthcare Full time
Job Title: Senior Operations Analyst Managed Care

Northwestern Memorial Healthcare is seeking a highly skilled Senior Operations Analyst Managed Care to join our team. As a key member of our managed care operations team, you will be responsible for ensuring the smooth operation of our managed care contracts and programs.

Key Responsibilities:
  • Supervise and govern the Payer Plan code assignment process for all managed care contracts, including government and special project contracts.
  • Work with multiple operations departments to implement the operations of the managed care, government, and special project contracts.
  • Collaborate with the Director, Managed Care to plan and implement key tactics that support the Hospital's managed care strategy.
  • Develop and maintain validation processes for loading contract logic within the Epic patient accounting system.
  • Responsible for the distribution of all-important contracting documents to appropriate parties.
  • Support various departments through the escalation of tickets through the Service Now portal based on the appropriately assigned payor and/or category.
Requirements:
  • Bachelor's degree in Business Administration, Healthcare Management, Communications, or related field preferred or equivalent experience.
  • Minimum four years of relevant experience in a managed care organization, consulting firm, hospital system/hospital.
  • Excellent written and oral communications skills are necessary.
  • Strong organizational skills and experience with managed care contracting, healthcare operations, IT functions, and applications is essential.
  • Knowledgeable in A/R, Claims Management, or Patient Accounting functions.
  • Strong Project Management skills.
  • Proficiency in data analysis is a must.
Preferred Qualifications:
  • Eight or more years of relevant experience in a managed care organization, consulting firm, hospital system/hospital.

Northwestern Memorial Healthcare is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation, or any other protected status.



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