Managed Care Analyst at AdventHealth in MAITLAND, Florida

Job Description:

Description

AdventHealth Corporate

Location Address: 2600 Lucien Way, Maitland, FL 32751

All the benefits and perks you need for you and your family:

• Benefits from Day One
• Career Development
• Whole Person Wellbeing Resources

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule:  Full-Time

The role you’ll contribute:

The Managed Care Analyst applies technical, analytical, and problem-solving skills to provide solutions/improvements within the department.  Responsible for completing financial and/or operational analysis of contracts, developing and tracking key performance indicators, financial modelling comparative analysis and bench marking. This person demonstrates competences in decision support and reporting through converting raw data into useful and actionable information.  This person is responsible for compiling and analyzing data as well as for creating meaningful applications to support executive decision making. Character traits include: strong work ethic, trainability, communicative, team player all with a positive “can do” attitude. Intermediate Excel skills required.

The value you’ll bring to the team:

• Supports Managed Care leadership in financial modeling.
• Basic knowledge of contractual language as it relates to reimbursement methodologies
• Applies basic understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, CPT, HCPCS II, DRG and revenue codes
• Demonstrates knowledge of various reimbursement methodologies including, Per Diem, DRG, fee schedules, and percent of charge
• Demonstrates knowledge of commercial payers for modeling and analyzing contract proposals
• Performs analytical and planning functions in support of Managed Care decision making
• Participates in the annual Managed Care revenue budget process
• Utilizes a variety of software applications and data sources to produce the Managed Care Suite, DAA reports, other standard reporting, and adhoc reports         
• Evaluates actual contract performance against expected; analyzes data to distinguish patterns and recognize trends in contract performance
• Supports Senior Managed Care Analyst in timely and efficiently completing financial analyses related to Managed Care net revenue.
• Completes multiple projects in a fast-paced environment within timeframes outlined in the department policies and as specified by Leadership
• Adapts to new situations and changing priorities to accomplish project deadlines and department goals
• Demonstrates strong project management and organizational skills by maintaining up-to-date project lists to assist in setting appropriate project priorities
• Develop an understanding of reimbursement methodologies and their impact on internal systems and other departments

Qualifications

The expertise and experiences you’ll need to succeed:

• Associates Degree in Business, Accounting, Finance, Information Systems, or related.
• 1-3 years of experience in managed care, patient billing services, health insurance claims processing, contract management, finance, or accounting
• Microsoft Office (Excel PowerPoint, Word, Outlook, Visio, etc.)

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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