Senior Managed Care Analyst

Quest Group Executive Search and Staffing Solutions; United States; Hybrid; USD 90,000 - 130,000; Full time

Job summary

Quest Group Executive Search is partnering with a large acute care organization in the Dallas/Fort Worth area to recruit a Senior Managed Care Analyst. The role offers a hybrid schedule with one day per week onsite and the rest remote, collaborating with managed care and finance leaders on reimbursement optimization and contract modeling.

The successful candidate will analyze hospital and ASC payments, build contract models, and provide financial analyses to support payer negotiations and

Qualifications

• Bachelor's degree in business, finance, healthcare administration or related field.
• 5+ years of healthcare financial analysis, decision support or managed care experience.
• Experience with contract reimbursement modeling.
• Intermediate SQL skills, including queries, joins and aggregations.
• Advanced Excel skills.
• Experience with Power BI or Tableau.
• Experience with PMMC Contract Pro, Strata or similar contract modeling software is a plus.

Responsibilities

• Analyze hospital and ASC claims, payments and reimbursement trends.
• Build and maintain managed care contract models.
• Evaluate payer contract performance and identify reimbursement opportunities.
• Provide financial analysis to support payer negotiations.
• Analyze large healthcare data sets and translate findings into useful business information.
• Develop financial reports, dashboards and ad hoc analyses.
• Identify payment variances, reimbursement issues and financial trends.

Skills

SQL

Advanced Excel

Education

Bachelor's degree in business, finance, healthcare administration or related field

Tools

Power BI

Tableau

PMMC Contract Pro

Strata

Job description

Quest Group Executive Search is working with a large acute care organization in the Dallas/Fort Worth area to identify an experienced Senior Managed Care Analyst. This is a hybrid position with only one day per week required in the office. The remaining days can be worked remotely.

The Senior Managed Care Analyst will focus on managed care reimbursement, payer contract modeling and financial analysis. This person will work closely with managed care and finance leadership to evaluate contract performance and provide the analysis needed to support payer negotiations and strategic decisions.

Key Responsibilities

• Analyze hospital and ASC claims, payments and reimbursement trends
• Build and maintain managed care contract models
• Evaluate payer contract performance and identify reimbursement opportunities
• Provide financial analysis to support payer negotiations
• Analyze large healthcare data sets and translate findings into useful business information
• Develop financial reports, dashboards and ad hoc analyses
• Identify payment variances, reimbursement issues and financial trends

Qualifications

• Bachelor's degree in business, finance, healthcare administration or a related field
• 5+ years of healthcare financial analysis, decision support or managed care experience
• Experience with contract reimbursement modeling
• Intermediate SQL skills, including queries, joins and aggregations
• Advanced Excel skills
• Experience with Power BI or Tableau
• Experience with PMMC Contract Pro, Strata or similar contract modeling software is a plus

This is a great opportunity for someone with strong managed care analytics experience who wants the flexibility of working remotely most of the week while still being connected to the team.

Candidates must be able to work onsite in the Dallas/Fort Worth area one day per week.