Managed Care Analyst

Ascension • Full-time • Remote (United States) • $56.57k - $78.86k / year • 11h ago

Details

Department: Delivery Excellence
Schedule: Full-Time, 8-hour Day Shift, Monday-Friday, Remote
Facility: Ascension Connect LLC
Salary: $56,571.00 - $78,856.00

Benefits

Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.

Responsibilities

Track and trend claims and payments per managed care contracts. Work to facilitate appropriate and timely claims payments.

Identify compliance issues related to each contract; prepare reports to be presented to the payer with the total amount due. Calculate interest payments due.
Analyze claims and payment data to identify trends in denied or underpaid claims. Work with appropriate staff and payers to resolve issues and facilitate payment.
Review language of managed care contracts. Participate in negotiations as assigned. Coordinate contract processing through legal review and execution.
Analyze financial results and related information. Compare to projections. Provide reports to appropriate parties.
Develop and generate regular and ad hoc reports for clinical and financial review and trending in order to analyze and compare information related to clinical procedures, payer categories, reimbursements, net income, net loss charges, costs, revenue and variances.

Requirements

Licensure / Certification / Registration:

Accountant preferred.
Fellow credentialed from the Healthcare Financial Management Association preferred.

Education:

High School diploma equivalency with 2 years of cumulative experience OR Associate's
degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.

Additional Preferences

Additional Preferences:

Minimum of 2 years of professional experience in health-care compliance, credentialing governance, audit analytics, or regulatory operations, preferred
Minimum of 2 years of professional experience in an analyst role, or, demonstrated proficiency in compliance, credentialing, or audit management systems (e.g., MD-Staff, Smartsheet, Tableau, Power BI, preferred).
Strong analytical and strategic thinking skills, with the ability to synthesize complex data into actionable solutions.
Expert knowledge of Microsoft Excel & Google sheets. Able to create formula's, pivot tables, spreadsheets and draw conclusion from data.

#ACVS

#LI-Remote

Why Join Our Team

Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Equal Employment Opportunity Employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.

For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Pay Non-Discrimination Notice

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

E-Verify Statement

This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.

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