Managed Care Data Analyst

Job Summary:

"Working and Living in Paradise"

Come join us in beautiful Sarasota, Florida as part of our Managed Care team for Sarasota Memorial Healthcare System. Sarasota is the home one of America's #1 beaches. Located minutes from the beautiful sandy beaches of Florida's West Coast, our Magnet hospital is continuing to grow and expand Sarasota Memorial Health Care System is a community-owned regional medical center and leading acute care hospital and named by U.S. News & World Report as one of "America's Best Hospitals;" ranking above all other Florida institutions in several specialties. These awards combined with our supportive team environment help to ensure your success. At Sarasota Memorial Hospital, you will be a part of a diverse environment where all people are valued and respected. At Sarasota Memorial's Patient Financial Services Department, you are an individual who's efforts breathe life into the world of the patient financial experience. With many roles and opportunties for professional growth, our Team empowers you to mold your future. Put your best foot forward and submit your application today.

Our Managed Care Data Analyst works with Managed Care Analyst Sr to oversee the balancing, reconciling, and resolution of errors for the daily 835 and 837 files, charges, payments, adjustments and contractuals to the patient accounts receivable system. Provides training, guidance, and support with the use of the managed care contracting system by Patient Financial Services (PFS) and other Revenue Cycle team members through education and daily communication. Oversees the Master Tables as assigned and collaborates with the Managed Care team to implement process improvements. Provides guidance and support for other system maintenance functions as required for data integrity of the contract modeling software. Develops reports/report views and explains and interprets data as requested and maintains report libraries. Collaborates with Managed Care Analyst Sr in modeling proposed contracts and loading finalized contracts. Oversees all contract naming conventions, organization of payor models, organization of scanned and paper contracts, rate schedules, payor correspondence, and the managed care website. Performs other duties as assigned in support of the Managed Care Department.

Required Qualifications:

• Require a bachelor's degree in a relevant field of study.
• Require experience in at least two (2) of the following: Microsoft Excel data analysis, Microsoft PowerPivot / SSAS, Power BI, SQL Server (coding or database maintenance), SSRS, RStudio, Python, PowerShell, or other similar analytics toolset or programming language.

Preferred Qualifications:

• Prefer experience in a managed care setting.
• Prefer knowledge of health insurance plans and managed care contracts.
• Prefer proficient excel user with experience using complex formulas and pivot tables.
• Prefer previous experience in generating a variety of reports.
• Prefer coding certificate (i.e. CPC) or CPAT/CRCS.
• Prefer demonstrated knowledge of hospital billing, including hospital charges, CPT, DRG, APC, APRDRG, revenue codes, and ASC Groupers
• Prefer demonstrated knowledge of contract modeling software, contract terms, and contract modeling.
• Prefer demonstrated ability to relate to a wide variety of people using excellent written and verbal communication skills.
• Prefer demonstrated organizational, analytical, leadership and judgment skills.
• Prefer demonstrated proficiency with Windows-based office applications including Excel, Word, PowerPoint, Access, and Outlook.
• Prefer knowledge and experience with hospital and physician billing, payer claims adjudication and analyzing payment patterns.

Preferred Education:

M D: Masters Degree

Work Days/Shift/Start Time:

Reputation. Community. Impact. Growth.

Every day, our patients at Sarasota Memorial Health Care System receive a first-class experience in care from a team on a mission to deliver the highest level of care in America. In the process of rising to that challenge, one by one, our people are finding their purpose and feeling their impact. Now it is your turn to see yourself here.

Recognition:

• 5- Star Quality Rating- SMH- Sarasota is the only hospital in Florida to earn the federal Centers for Medicare & Medicaid Services' highest rating every year since its inception.

• 50 Best Hospitals- SMH ranked among U.S. News & World Report's 50 Best Hospitals in two specialties, Rehabilitation and Obstetrics/Gynecology in , and among the nation's top 10% high peformers in 18 other medical specialties, procedures and conditions.

• World's Best Hospitals- SMH- Sarasota has made Newsweek's prestigous list six years in a row, since the global rankings began in 2019.

• "A" for Patient Safety- SMH- Sarasota has earned straight A's since it began participating in the Leapfrog Group's hospital safety survey in 2016.

• Magnet Hospital- SMH has been recognized as a Magnet hospital for the past 20 years by the American Nurses Credentialing Center, a continuous achievement for nursing excellence shared by less than 1% of hospitals nationwide.

• America's Best Employer/Workplace- SMH topped Forbe's list of America's Best Employers, ranking among the top 20% of large employers across all industries in 2024, and #1 healthcare employer in Florida in 2023. The health system also earned a 5-star rating in Newsweek's 2024 list of "America's Greatest Workplaces for Women."

The benefits of being the best:

Our commitment to becoming the best community hospital and health care system means providing the best possible benefits to our people. Some highlights:

Total Rewards Package

• Paid Time Off (start earning PTO on day one of employment)
• Tuition Reimbursement
• Discounted Medical, Prescription, Dental, Vision Benefit Plans for Full & Part-Time Employees
• Flexible Spending Accounts (Health Care and Dependent Care) - Pre-Tax Dollars
• Life Insurance
• Competitie rates
• Bonuses offered
• Disability Insurance
• Retirement Savings Plan: 403b
• Sarasota Campus for now - Discounted Child Care & Before and After School Program and Summer Camp
• Bereavement Leave
• Free Parking
• On Campus Dining w/ a 10% discount
• Credit Union w/ teller machines on campus
• Direct Deposit
• Free Wellness Screening
• Free confidential counseling services
• Employee Discount Programs
• Recognition Programs
• Referral Programs
• Tremendous growth opportunities for hard workers