Physician Managed Care Analyst - Remote

Tenet Healthcare; Frisco (TX); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare services provider in Frisco, Texas, is seeking an experienced Managed Care Analyst to oversee managed care information analysis and contract management. The ideal candidate will have over 5 years of relevant experience and a comprehensive understanding of reimbursement practices. This role offers competitive pay up to $25.70 per hour and a comprehensive benefits package, along with opportunities for career advancement.

Benefits

Salary up to $25.70 per hour

Potential signing bonus

Comprehensive benefits package

Paid time off

401k plan with employer match

Career advancement opportunities

Qualifications

• 5+ years of managed care experience within a relevant environment.
• Understanding of health policy and reimbursement methodologies.
• Capability to perform data analysis and communicate findings.

Responsibilities

• Analyze managed care information for compliance.
• Develop policies and documentation.
• Maintain contract databases and fee schedules.
• Research contracts for negotiation.

Skills

Managed care experience

Reimbursement methodologies knowledge

Analytical skills

Communication skills

Tools

EPIC billing system

IDX billing system

Job description

Overview

Employer Industry: Healthcare Services

Why consider this job opportunity

• Salary up to $25.70 per hour
• Potential for a signing bonus for qualified new hires
• Comprehensive benefits package including medical, dental, vision, and life insurance
• Paid time off starting with a minimum of 12 days per year, plus 10 paid holidays
• 401k plan with up to 6% employer match
• Opportunities for career advancement within a supportive healthcare environment

What to Expect (Job Responsibilities)

• Serve as the primary analyst for managed care information, including health plan-specific policies, for internal departments
• Conduct research to assist in the development of policies, procedures, and internal documentation
• Maintain fee schedules and contract databases by collecting client contracts and organizing terms
• Analyze payment data related to managed care contracts to ensure compliance and communicate findings
• Coordinate claim reprocessing projects and research contracts for negotiation when necessary

What is Required (Qualifications)

• Minimum of 5 years of managed care experience within a managed care organization, physician, IPA, or billing environment
• Comprehensive understanding of reimbursement methodologies, fee schedules, HCPCS, CPT4, ICD9, CCI edits, and claims adjudication practices
• Knowledge of EPIC and IDX billing systems preferred
• Ability to work in a sitting position, use a computer, and answer telephones
• Ability to travel and walk through hospital-based departments across broad campus settings

How to Stand Out (Preferred Qualifications)

• Familiarity with revenue cycle management and managed care contracting-related fields
• Experience working in a hospital environment or similar healthcare setting
• Strong analytical skills and experience with data analysis in a managed care context
• Demonstrated ability to effectively communicate with diverse audiences
• Proven track record of successful project management in a healthcare setting

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