Managed Care Analyst, Financial Admin, Full Time, Day

04 Valley Health System; United States; On-site; USD 74,000 - 93,000; Full time

Benefits offered by this job

Medical discounts

Life Insurance

FSA/Commuter plans

Disability benefits

Paid holidays & PTO

Fitness center membership

Day care discounts

Job summary

Valley Health System is seeking a Payor Contracting Analyst to support enterprise-wide managed care contracting initiatives, analyze claim and denial trends, and provide oversight of payer contract compliance across the system.

The role also serves as a key resource on regulatory developments, with responsibilities in revenue forecasting and contract modeling, and education on industry changes for system stakeholders.

Qualifications

• Bachelor's degree required in economics, business administration, health care administration or related field.
• MBA or MHA degree preferred.
• Minimum two years' experience with payor or provider contracting in health care.

Responsibilities

• Support payor contracting and analysis activities for the system.
• Analyze claim and denial/payment trends and ensure contract compliance.
• Provide education on insurance industry changes and payer policies.
• Offer analytical support for revenue forecasting and contract modeling.

Skills

Analytical skills

Communication skills

Organizational skills

Critical thinking

Education

Bachelor's degree in economics, business administration, health care administration or related subject

MBA or MHA preferred

Job description

Position Summary

This position supports activities of payor contracting and analysis for the Valley Health System. This position assists with enterprise-wide managed care contracting initiatives through analysis of claim and denial/payment trends and provides oversight of payer contract compliance for the system. This position is also a key resource to system stakeholders on new regulatory and legislative developments pertaining to the Federal Price Transparency and the No Surprises Act legislations. The position provides analytical support to other areas within the system (VMG, Population Health, ColigoCare, etc.) as it pertains to revenue forecasting, contract modeling, denial and payment variance analysis and trends. This position also serves as a one of the key subject matter experts for the system for any education related to insurance industry changes, managed care regulation, and impactful payer policies/protocol changes.

Education

Bachelor's degree in economics, business administration, health care administration or related subject is required. MBA or MHA degree preferred.

Experience

A minimum of two years' experience with payor or provider contracting in a health care setting, knowledge of the healthcare industry and payor reimbursement methodologies.

Special Skills

Excellent analytical skills, with attention to detail and accuracy required. Strong communication and interpersonal skills required. Excellent written, organizational, and critical thinking skills required.

Job Location

Job Location Kraft Center Shift Day (United States of America)

Benefits

• Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees)
• Group Term Life Insurance and AD&D(Full Time Employees)
• Flexible Spending Accounts and Commuter Benefit Plans
• Supplemental Voluntary Benefits ( e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.)
• 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness Retirement Plan Tuition Assistance Employee Assistance Program (EAP)
• Valley Health LifeStyles Fitness Center Membership Discount
• Day Care Discounts for Various Daycare Facilities

Salary

Salary Joining Valley Health System means becoming part of a dedicated team that values the highest quality of care in a supportive environment. In our commitment to high performance and reliability, we encourage and recognize exceptional individual performance through our industry leading compensation practices including a starting salary and benefits in accordance with your role, experience, education, and licensure. Actual individual salaries vary depending on these factors. The salary listed does not include other forms of compensation or benefits. Pay Range: $74,214.40 - $92,768.00 The posted pay range reflects the compensation for a full-time equivalent (1.0 FTE)

EEO Statement

Valley Health System does not discriminate on the basis of ancestry, age, atypical hereditary cellular or blood trait, civil union status, color, creed, disability, domestic partnership, gender, gender identity or expression, familial status, genetic information, liability for service in the Armed Forces of the United States, marital status, medical condition or illness, mental or physical handicap, national origin, nationality, perceived disability, pregnancy, race, refusal to submit to genetic testing or make available results of such tests, religion, sex, sexual orientation, veteran’s status or any other protected basis, in accordance with all applicable Federal, State and Local laws. This applies to all areas of employment, including recruitment, hiring, training and development, promotion, transfer, termination, layoff, compensation, benefits, social and recreational programs, and all other conditions and privileges of employment. Valley Health System is proud of our commitment to improving the lives of our patients, our staff, and the communities we serve. When you join Valley, you’re joining a team of people who believe in delivering quality care in a supportive environment where top performance is both nurtured and recognized. Our culture is built on going the extra mile, doing what’s right, and always striving to be better together.