Healthcare Revenue Analytics Lead (Managed Care)

Hoag Health System; Costa Mesa (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

Hoag Memorial Hospital Presbyterian is seeking a Revenue Analyst II to serve as a technical expert in a healthcare setting with emphasis on managed care and government reimbursement. You will support contract modeling, revenue impact analyses, and month-end close reporting within the Finance Revenue team.

The role involves identifying underpayments, tracking profitability of managed care contracts, and assisting in Medicare/Medi-Cal reimbursement analyses.

Qualifications

• Bachelor’s degree in business administration, finance, accounting, or healthcare administration.
• 2-3 years’ experience as an analyst in a healthcare environment with emphasis on managed care reporting and reimbursement
• General understanding of DRG and CPT/HCPC Medical Coding and Medical Terminology. Strong understanding of Managed Care and Government reimbursement methodologies
• General knowledge of hospital operations (Revenue Cycle: Registration, Patient Accounting/Billing, data processing).
• Understanding of Accounting Principles and Hospital Financial Reporting.

Responsibilities

• As part of the Finance Revenue team, this position will support Managed Care Contracting for contract modeling and revenue impact analysis in support of negotiations, helping to identify underpayments, and tracking profitability within our managed care contracts.
• This position will also prepare analyses related to the financial impact of Medicare and Medi-Cal changes in reimbursement in order to identify financial and or operational impacts to revenue.
• As part of other on-going responsibilities, the position will support the Revenue Finance Team with adhoc revenue impact analysis related to items such as payer mix, acuity, reimbursement, and volume.
• The incumbent will also own and maintain specific recurring reporting related to month end close and provide support in the development of each years Operating Revenue Budget.

Education

Bachelor’s degree in business administration, finance, accounting, or healthcare administration

Job description

Hoag Memorial Hospital Presbyterian is seeking a Revenue Analyst II to serve as a technical expert in a healthcare setting with emphasis on managed care and government reimbursement. You will support contract modeling, revenue impact analyses, and month-end close reporting within the Finance Revenue team.

The role involves identifying underpayments, tracking profitability of managed care contracts, and assisting in Medicare/Medi-Cal reimbursement analyses.