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Preference will be given to candidates in California or Oregon who are close to one of our Adventist Health locations. This position will be working heavily in healthcare contracts, reimbursement, and regulations. So understanding of California Health Plans, Insurance, and healthcare contracts is a must for the role.
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:
Supports managed care contracting through the development of various financial models and rates to assist in negotiations. Uses knowledge of managed care contract reimbursement and working knowledge of a contract management system application to provide an accurate evaluation of data results along with the ability to clearly communicate any financial impact and insights from the results to managed care and AH leadership. Utilizes a strong technical knowledge of spreadsheets and database system applications as the tools and skills necessary to provide timely and accurate financial analysis and reporting.
Job Requirements:
Education and Work Experience:
- Associate's Degree or equivalent combination of education/related experience: Required
- Bachelor's Degree or equivalent combination of education/related experience: Preferred
- Five years' related experience: Preferred
- Experience working in Healthcare setting: Strongly Preferred
Essential Functions:
- Develop and prepare methods for data gathering and manipulation from multiple systems and sources as needed for the preparation of analytic financial models and reports.
- Sets up and maintains model/simulation rate terms within the contract management system and evaluate the results as needed for upcoming negotiations.
- Develops, analyzes, evaluates and prepares contract rates and terms when needed for a payer network proposal/counter proposal during negotiations.
- Keeps abreast of changes involving federal (CMS) and state Medicaid reimbursement rates and schedules. Assists in maintaining the methods needed in producing the standard CMS Medicare and Medicaid equivalent benchmark values.
- Assists with the managed care budgeting schedule preparation and forecasting of targeted increases with assumptions.
- Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
