Managed Care Analyst

Wheeler Staffing Partners; Dallas (TX); On-site; USD 41,328 - 53,726; Part time

Job summary

Wheeler Staffing Partners in Dallas, TX is seeking an experienced Managed Care Analyst for an open-ended contract on-site. The role supports contract management and pricing system implementation by reviewing, validating, and preparing managed care contracts for system conversion.

The ideal candidate has extensive healthcare contract management, payer terminology, and advanced Excel skills, with the ability to interpret complex contracts and ensure accuracy before loading data into the new

Qualifications

• Minimum of five (5) years of experience in managed care, healthcare contract management, or revenue cycle operations.
• Strong knowledge of managed care contracts, reimbursement methodologies, and payer terminology.
• Experience interpreting complex healthcare contract language.
• Advanced Microsoft Excel skills, including Pivot Tables, VLOOKUP, XLOOKUP, and basic formulas.
• Strong analytical, critical thinking, and problem-solving skills.
• Excellent organizational and time management skills with the ability to manage multiple priorities simultaneously.
• Strong written and verbal communication skills.
• Ability to work independently while collaborating effectively with cross-functional teams.

Responsibilities

• Review managed care contracts, amendments, and supporting documentation to ensure all required information is complete for system implementation.
• Interpret complex contract language, reimbursement methodologies, and payer terms.
• Validate fee schedules, rate tables, and contract attachments for completeness and accuracy.
• Confirm reimbursement provisions, payment methodologies, and contractual obligations are properly documented.
• Identify missing, inconsistent, or unclear contract information and collaborate with internal stakeholders to resolve discrepancies.
• Prepare contracts and supporting documentation for accurate loading into the contract management system.
• Validate CPT, HCPCS, and ICD-10 billing codes associated with reimbursement terms.
• Review UB-04 billing information and healthcare documentation to ensure contract compliance.
• Maintain detailed documentation of contract reviews, approvals, and validation activities.
• Ensure confidential healthcare and contract information is handled with accuracy and discretion.
• Support quality assurance efforts by identifying potential errors before system implementation.

Skills

Excel

Analytical skills

Communication

Independent work

Cross-functional collaboration

Payer terminology

Tools

Power Query

VBA

SQL

Job description

Employment Type: Contract | Open-Ended Assignment

Work Arrangement: 100% Onsite

Compensation: $30.00–$39.00 per Hour (Based on Experience)

Position Overview

Wheeler Staffing Partners is seeking an experienced Managed Care Analyst for an open-ended contract opportunity in Dallas, TX. This fully onsite position supports the implementation of a new contract management and pricing system for ambulatory surgery centers by reviewing, validating, and preparing managed care contracts for system conversion.

The ideal candidate has a strong background in healthcare contract management, managed care, or revenue cycle operations with the ability to interpret complex payer agreements, validate reimbursement methodologies, and ensure contract accuracy prior to system implementation. This role requires exceptional analytical skills, attention to detail, and advanced Microsoft Excel proficiency.

Key Responsibilities

Contract Review & Analysis

• Review managed care contracts, amendments, and supporting documentation to ensure all required information is complete for system implementation.
• Interpret complex contract language, reimbursement methodologies, and payer terms.
• Validate fee schedules, rate tables, and contract attachments for completeness and accuracy.
• Confirm reimbursement provisions, payment methodologies, and contractual obligations are properly documented.
• Identify missing, inconsistent, or unclear contract information and collaborate with internal stakeholders to resolve discrepancies.
• Prepare contracts and supporting documentation for accurate loading into the contract management system.

Data Validation & Compliance

• Validate CPT, HCPCS, and ICD-10 billing codes associated with reimbursement terms.
• Review UB-04 billing information and healthcare documentation to ensure contract compliance.
• Maintain detailed documentation of contract reviews, approvals, and validation activities.
• Ensure confidential healthcare and contract information is handled with accuracy and discretion.
• Support quality assurance efforts by identifying potential errors before system implementation.

Process Improvement

• Assist with improving contract intake, review, and validation processes.
• Collaborate with system analysts and cross-functional teams to support successful implementation efforts.
• Recommend workflow improvements that increase efficiency and contract accuracy.
• Support ongoing managed care and revenue cycle initiatives as assigned.

Required Qualifications

• Minimum of five (5) years of experience in managed care, healthcare contract management, or revenue cycle operations.
• Strong knowledge of managed care contracts, reimbursement methodologies, and payer terminology.
• Experience interpreting complex healthcare contract language.
• Working knowledge of CPT, HCPCS, ICD-10 coding, UB-04 billing forms, and healthcare reimbursement practices.
• Advanced Microsoft Excel skills, including Pivot Tables, VLOOKUP, XLOOKUP, and basic formulas.
• Strong analytical, critical thinking, and problem-solving skills.
• Exceptional attention to detail with a high level of accuracy.
• Excellent organizational and time management skills with the ability to manage multiple priorities simultaneously.
• Strong written and verbal communication skills.
• Ability to work independently while collaborating effectively with cross-functional teams.

Preferred Qualifications

• Experience with contract management, pricing, or claims adjudication systems.
• Knowledge of Managed Care and Revenue Cycle Management operations.
• Familiarity with No Surprises Act compliance requirements.
• Experience using Power Query, VBA, SQL, or other database tools.
• Previous experience supporting Ambulatory Surgery Centers (ASCs).
• Experience working within healthcare organizations is a plus.