Associate Managed Care Analyst

Highmark Health; Pennsylvania; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented Associate Managed Care Analyst to join their dynamic team. This role focuses on building and maintaining hospital contracts, managing underpayment accounts, and collaborating with finance teams to optimize reimbursement strategies. The ideal candidate will possess strong analytical skills, a background in finance, and the ability to interpret complex data sets. Join a forward-thinking organization that values innovation and teamwork, providing you with the opportunity to make a significant impact in the healthcare sector while enjoying a supportive work environment.

Qualifications

• Experience in finance, contracting, or data analysis.
• Ability to analyze and interpret various types of data.

Responsibilities

• Build and maintain hospital and ASC contracts in Epic.
• Manage underpayment AR for assigned payors.

Skills

Data Analysis

Financial Analysis

Communication Skills

Project Management

Microsoft Office

Statistical Tools (R, Python)

Education

Associate's degree in Finance

Bachelor's degree in Finance

Tools

Epic

Microsoft Excel

Microsoft PowerPoint

Job description

Thank you for your interest in employment at a Highmark Health company. Highmark Health uses an online application process. If you participate in the online application process through this Workday site, your personal information will be collected, including but not limited to data such as your resume and resume content, education, contact information, address, city, postal code, country, phone number, email address, IP address, as well as any other personal information you choose to provide. As part of the online application process, we will provide details such as how we will use the data that we collect and where such information is processed. We will also ask for your consent to use the data for purposes contained in the Highmark Health Data Protection Statement and the GDPR Data Protection Consent for Job Applicants, and for all other permissible purposes.

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Associate Managed Care Analyst

Apply remote type Remote locations PA, Working at Home - Pennsylvania time type Full time posted on Posted Yesterday job requisition id J263871

Company :

Allegheny Health Network

Job Description :

GENERAL OVERVIEW:

This job builds and maintains hospital, professional, and ASC contracts in Epic. Identifies underpaid accounts and articulates the source of the processing error to the payor.

ESSENTIAL RESPONSIBILITIES

• Provides support to senior analysts in building hospital, professional, and ASC contracts in Epic. (40%)
• Manages underpayment AR for assigned payors including successfully recovering on underpaid accounts. (25%)
• Collaborates with Revenue Cycle and Finance Teams on contract building and analysis requests. (25%)
• Provides assistance in performing analyses to support reimbursement impact analysis. (10%)
• Perform other duties as assigned or required.

QUALIFICATIONS:

Minimum

• Associate's degree in Finance, Accounting, Business Administration, Economics, Statistics, or Related Field
• Experience in finance, contracting, or data analysis
• Microsoft Office (Excel, PowerPoint, etc.)
• Ability to analyze and interpret various types of data including financial results, operational metrics, clinical outcomes, and other key datasets
• Ability to work with large quantities of detailed data and illuminate the higher-level strategic insights that can impact business operations and performance
• Ability to juggle multiple projects at once and manage time effectively, in order to meet established deadlines
• Strong oral and written communication skills
• Ability to independently make progress on key projects with support from supervisor or peer analysts
  

Preferred

• Bachelor's degree in Finance, Accounting, Business Administration, Economics, Statistics, or Related Field
• Epic Expected Reimbursement Contracts Certification
• Experience with hospital, physician, and ASC contracts
• Experience in healthcare
• R, Python, or other statistical/programming tools
• Knowledge of healthcare industry, particularly as it relates to hospitals or other providers reimbursement methodologies
• Clinical background or general understanding of hospital/physician practice operations

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$33.11

Pay Range Maximum:

$52.14

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at [e-mail]

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Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network.

Based in Pittsburgh, Pa., Highmark Health’s 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services.

Highmark Health’s businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.