Supervisor - Managed Care Analysis

Baptist Health Care; Pensacola (FL); On-site; USD 60,000 - 80,000; Full time

Job summary

Baptist Health Care in Pensacola, Florida is seeking a Managed Care Analyst to support financial analysis and managed care contracts. This position involves modeling reimbursement methodologies and collaborating closely with diverse teams for optimal reimbursement and revenue integrity.

The successful candidate will analyze contract performance and contribute to payer negotiations with a strong understanding of healthcare reimbursement. Bachelor's degree or equivalent experience required. This role offers a comprehensive approach in a collaborative environment.

Qualifications

• 3 years' experience in managed care contract modeling or healthcare financial analysis.
• 1 year experience in Epic reimbursement modules.
• 1 year experience in payer negotiations and renewals.

Responsibilities

• Develops and maintains financial models for managed care contracts.
• Models complex reimbursement methodologies.
• Analyzes contract financial impact to support negotiations.

Skills

Healthcare reimbursement methodologies

Advanced Excel skills

Reimbursement modules proficiency

Healthcare revenue cycle knowledge

Written and verbal communication

Collaborative teamwork

Data analysis and interpretation

Education

Bachelor's Degree in Business, Finance, Health Care Administration

Four years of related experience may be considered

Job description

The Managed Care Analyst supports the financial analysis, modeling, and implementation of managed care contracts within Epic. This role translates contract terms into accurate reimbursement models, evaluates contract performance, and supports payer negotiations through data-driven insights. The position partners closely with Managed Care, Revenue Cycle, Finance, and Epic application teams to ensure contract accuracy, optimal reimbursement, and revenue integrity.

Responsibilities

• Develops and maintains financial models for proposed and existing managed care contracts.
• Models complex reimbursement methodologies including DRG, APC, per diem, case rates, and fee schedules.
• Analyzes contract financial impact to support payer negotiations and leadership decision-making.
• Performs expected vs. actual reimbursement variance analysis.
• Translates executed contract language into Epic reimbursement contract build.
• Configures and maintains expected reimbursement and fee schedules in Epic.
• Performs Epic testing and validation prior to production release.
• Partners with Epic application teams to resolve reimbursement discrepancies.
• Monitors managed care contract performance and identify underpayments.
• Supports audits, reconciliations, and payer disputes.
• Collaborates with Managed Care, Revenue Cycle, Finance, and Operational teams.
• Communicates complex reimbursement concepts to non-technical stakeholders.

Qualifications

• Bachelor's Degree Business, Finance, Health Care Administration, Related field Required or
• Four years of related experience may be considered in lieu of degree Required
• 3 years' Experience in managed care contract modeling or healthcare financial analysis experience. Required
• 1 year Experience in Epic reimbursement modules. Preferred
• 1 year Experience supporting payer negotiations and renewals. Preferred
• 1 year Experience in a multi-facility health system. Preferred
• 1 year Experience with Medicare, Medicaid, and commercial reimbursement Preferred

Licenses and Certifications

• Epic certification(s) in relevant modules. Upon Hire Preferred

Required Skills, Knowledge and Abilities

• Strong understanding of healthcare reimbursement methodologies.
• Advanced Excel skills.
• Demonstrated proficiency in reimbursement modules.
• Knowledge of healthcare revenue cycle operations and workflows.
• Excellent written and verbal communication skills.
• Ability to work collaboratively with diverse teams.
• Strong ability to analyze, interpret, and evaluate data.

Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law. Certain positions may require a Level 2 Background check through AHCA. Additional information about this requirement can be found here: Florida Care Provider Background Screening Clearinghouse