Managed Care Analyst

InGenesis; Houston (TX); On-site; USD 90,000 - 120,000; Full time

Job summary

InGenesis is seeking a Managed Care Analyst to build and optimize managed care contracts within Epic’s Contract Maintenance and Contract Modeling for Hospital Billing and Professional Billing. The role requires strong Epic system knowledge, healthcare reimbursement experience, and advanced analytical skills.

The candidate will work with Finance, Managed Care, Revenue Cycle, IT, and operations to translate complex contract terms into actionable insights and robust dashboards, while supporting

Qualifications

• Bachelor's degree in a related field such as Business Admin, Healthcare mgmt, Finance or Economics.
• Epic Resolute HB or PB certification or hire; HB and PB certifications within 180 days of hire.

Responsibilities

• Build, test, implement, and maintain managed care contracts in Epic for HB and PB.
• Configure contract rules and extensions to ensure accurate payment modeling.
• Perform system build and maintenance in Epic environments and upgrades.
• Develop reports and dashboards using Epic, SAP BI, StrataJazz, Power BI, and Excel.

Skills

Epic knowledge

Healthcare reimbursement

Analytical skills

Stakeholder comms

Education

Bachelor's degree

Tools

Epic HB/PB

Power BI

SAS/SQL

Job description

InGenesis is currently seeking a Managed Care Analyst to work with our client. In this role, you will be responsible for building, maintaining, optimizing, and analyzing managed care contracts within Epic's Contract Maintenance and Contract Modeling modules for both Hospital Billing (HB) and Professional Billing (PB). This role helps ensure accurate reimbursement calculations, contract integrity, and financial performance.

The ideal candidate will have strong Epic system knowledge, healthcare reimbursement experience, and advanced analytical skills. This position works closely with Finance, Managed Care, Revenue Cycle, IT, and operational teams to translate complex contract terms and data into actionable business insights.

Key Responsibilities

Epic Contract Management

• Build, test, implement, and maintain managed care contracts in Epic to support accurate reimbursement calculations.
• Configure HB and PB contract rules, components, and extensions to ensure accurate payment modeling across multiple service lines.
• Perform system build and maintenance in Epic environments, including Hyperdrive, Text, PJX/SUP, REL, and Data Courier.
• Participate in Epic upgrades, testing, and system enhancement projects.
• Maintain Epic certifications and stay current on Epic functionality and industry best practices.
• Utilize Epic Reporting, SAP Business Intelligence, and advanced Excel tools for contract management and analysis.

Analysis and Reporting

• Perform qualitative and quantitative analysis related to reimbursement, revenue cycle performance, and managed care contracts.
• Analyze contract performance, payer trends, denials, and regulatory changes to identify improvement opportunities.
• Present findings in a clear, meaningful, and actionable format.
• Develop reports, dashboards, and data visualizations using Epic, SAP BusinessObjects, StrataJazz, Power BI, and Excel.
• Create self-service reporting solutions that support data-driven decision making.

Contract Modeling and Reimbursement Analysis

• Interpret managed care contract language and accurately model payment terms within Epic.
• Evaluate reimbursement methodologies, including CPT, HCPCS, MS-DRG, APC, and ICD-10 coding structures.
• Monitor contract performance to ensure compliance, accuracy, and reimbursement optimization.
• Maintain knowledge of Medicare, Medicaid, Medicare Advantage, and commercial payer reimbursement guidelines.
• Identify revenue opportunities, financial risks, and cost-saving initiatives through contract analysis.

Collaboration and Customer Support

• Work with internal stakeholders to gather requirements, provide updates, and deliver results.
• Communicate technical and analytical information to both technical and non-technical audiences.
• Partner with Patient Access, Financial Services, Managed Care, IT, and Revenue Cycle teams to support organizational goals.
• Maintain documentation, workflows, and best practices related to Epic contract management and reporting.
• Support process improvement efforts to enhance workflow efficiency and data integrity.
• Participate in team training and knowledge-sharing activities.
• Perform other duties as assigned.

Required Qualifications

• Bachelor's degree in Business Administration, Healthcare Management, Hospital Administration, Finance, Statistics, Economics, Industrial Engineering, Information Services, or a related field.
• Epic Resolute Hospital Billing (HB) Expected Reimbursement Contracts Administration Certification or Epic Resolute Professional Billing (PB) Expected Reimbursement Contracts Administration Certification upon hire.
• Must obtain both HB and PB Expected Reimbursement Contracts Administration Certifications within 180 days of hire.

Preferred Qualifications

• Master's degree in a related field.
• Five (5) or more years of managed care, healthcare reimbursement, or revenue cycle experience.
• Experience working with Epic.
• Experience using SAP BusinessObjects (WebI/SAP Universes) or similar reporting and analytics tools.
• Advanced training or certification in Healthcare Analytics, Data Science, or Revenue Cycle Management.
• Current HB and PB Expected Reimbursement Contracts Administration Certifications.
• Additional certifications such as CPC, COC, CCS, HFMA CHFP, CRCR, or similar healthcare finance, coding, or contract management credentials.
• Experience with payer relations, contract negotiations, or healthcare decision support systems.
• Experience using Epic Reporting, SlicerDicer, StrataJazz, Power BI, or similar reporting platforms.

EEO Statement:

InGenesis is an equal opportunity employer committed to fostering a diverse, inclusive, and equitable workplace. We comply with all applicable federal, state, and local employment laws, including recent executive orders, and strictly prohibit discrimination, harassment, or retaliation based on race, color, religion, sex, sexual orientation, gender identity, national origin, disability, genetic information, age, veteran status, or any other characteristic protected by law.

InGenesis is dedicated to making reasonable accommodations for qualified individuals with disabilities and ensuring that all employment decisions are based on qualifications, merit, and business needs. If you require a reasonable accommodation during the hiring process, please contact us by visiting our website at https://www.ingenesis.com/careers/site-accommodations.

With decades of experience, InGenesis has grown into one of North America’s most trusted Healthcare Services Firms, which includes comprehensive health and workforce solutions. As the industry landscape shifts with new challenges in patient care, quality and compliance requirements, workforce retention, and operational efficiencies, we deliver strategic, data-driven solutions that include redefining workforce management and clinical service delivery. Explore InGenesis to discover how our expertise, innovative strategies, and commitment to excellence are shaping the future of healthcare workforce solutions. Join us in celebrating the professionals who define the next era of healthcare.