Director Managed Care Contract Analysis

Children's Health; Dallas (TX); Remote; USD 100,000 - 130,000; Full time

Job summary

Children's Health is seeking a Director of Managed Care Contract Analysis to oversee financial analytics related to hospital billing and support data reporting. The role involves managing a team of analysts and ensuring compliance with Medicaid regulations. Ideal candidates will have extensive experience in financial analysis and healthcare contract modeling, complemented by relevant certifications.

Benefits

Medical plan premiums covered after 3 years.

Employee savings plan match (4%-10%).

Paid Parental Leave (up to 12 weeks).

Caregiver Leave.

Adoption and surrogacy reimbursement.

Qualifications

• At least 7 years in financial analysis and reporting.
• Minimum of 5 years in healthcare contract modeling.
• EPIC certification for Hospital and Professional Billing required.

Responsibilities

• Conduct financial impact analysis and present recommendations.
• Extract and analyze data from databases and systems.
• Monitor changes in Texas Medicaid regulations.

Skills

Financial analysis

Data mining

Reporting

Contract modeling

Management

Education

Bachelor's degree or equivalent experience

Advanced degree or professional experience

Tools

EPIC

Crystal

STRATA

Job description

Job Title & Specialty Area: Director Managed Care Contract Analysis

Department:

Managed Care

Location:

Dallas, TX

Shift:

Monday thru Friday 8:00 a.m. to 5:00 p.m.

Job Type:

Remote

Why Children’s Health?

At Children's Health, our mission is to Make Life Better for Children. We aim to deliver exceptional patient and family experiences through innovative treatments and our affiliation with UT Southwestern. We are dedicated to promoting children's health beyond our organization, impacting the broader community for a healthier future.

Summary:

Oversee analytics related to Managed Care hospital and professional billing, including contract financial interpretation, modeling, audits, and revenue opportunities. Develop financial proposals within budget, analyze contract performance, and present findings to leadership. Support data reporting needs and collaborate across departments to ensure contract performance and analytic requirements are met. Manage a team of analysts to ensure proper training and resources.

Responsibilities:

1. Conduct financial impact analysis of hospital and professional contract negotiations, including modeling and reporting, and present recommendations to leadership.
2. Extract and analyze data from systems like Crystal, EPIC, STRATA, and other databases; evaluate report needs.
3. Maintain and update contracts and amendments in EPIC, ensuring accuracy and compliance.
4. Monitor and communicate changes in Texas Medicaid & Healthcare Partnership regulations and model their impact.
5. Oversee programming and analysis of EPIC Contract Management applications.

How You’ll Be Successful:

Work Experience:

• At least 7 years in financial analysis, data mining, and reporting.
• At least 5 years in healthcare contract modeling.
• At least 7 years working with electronic health records, hospital billing systems, and databases.
• Minimum 5 years of management experience.

Education:

• Bachelor's degree or equivalent experience required.
• Advanced degree or professional experience preferred.

Licenses and Certifications:

• EPIC certification for Hospital and Professional Billing (Contract Management), 1 year required.

A Place Where You Belong

We prioritize our people, fostering a culture of respect, inclusion, and community engagement. We aim to create a workplace where everyone can contribute and thrive.

Holistic Benefits – How We’ll Care for You:

• Medical plan premiums covered after 3 years.
• Employee savings plan match (4%-10%).
• Paid Parental Leave (up to 12 weeks).
• Caregiver Leave.
• Adoption and surrogacy reimbursement.

Children’s Health is an equal opportunity employer, committed to diversity and inclusion in all employment practices.