Remote Epic Contract Modeling Analyst

Nemours Children's Health; Jacksonville (FL); On-site; USD 90,000 - 115,000; Full time

Job summary

Nemours Children's Health is seeking a Contract Modeling Analyst to join our team. The role is remote with occasional travel; applicants must reside in Florida and a list of other states.

Responsibilities include managing Epic reimbursement contracts and pricing, maintaining networks and masterfiles, and delivering analyses that support contract negotiations within our managed care framework. The ideal candidate has a Bachelor’s degree (or equivalent healthcare experience), Epic certifications,

Qualifications

• Bachelor’s degree required; or equivalent healthcare specific work experience may be used in lieu of degree.
• Epic Professional Billing Reimbursement Contracts Certification and Epic Hospital Billing Expected Reimbursement Contracts Certification required.
• 5+ years of demonstrated strong analytical skills with knowledge of patient accounts or healthcare contract analysis and reimbursement.

Responsibilities

• Develop, test, implement and maintain Epic reimbursement contracts including rate and fee schedule adjustments, CPTs and plan/provider/component updates for accurate AR.
• Implement and test contract proposals from contract management using EPIC modeling tool with executive summaries of financial impact for leadership.
• Develop, test, implement and maintain Epic pricing contracts with rate, fee schedule, CPTs and provider adjustments.
• Develop and maintain provider networks and fee schedules for facility/non-facility CPT codes and modifiers in EPIC.
• Develop, test, implement and maintain Epic’s Benefits Engine components and adjudication tables for accurate patient financial responsibility.
• Maintain Epic Payor and Plan masterfiles for comprehensive plan selection in patient registration and benefit estimation.

Skills

Analytical thinking

Healthcare contract analysis

Financial impact analysis

Education

Bachelor’s degree

Tools

Epic Modeling Tool

Epic Benefits Engine

Epic Payor and Plan Masterfiles

Job description

Nemours Children's Health is seeking a Contract Modeling Analyst to join our team. The role is remote with occasional travel; applicants must reside in Florida and a list of other states.

Responsibilities include managing Epic reimbursement contracts and pricing, maintaining networks and masterfiles, and delivering analyses that support contract negotiations within our managed care framework. The ideal candidate has a Bachelor’s degree (or equivalent healthcare experience), Epic certifications,