Job Information
Akumin Senior Managed Care Analyst in United States
The Senior Managed Care Analyst works under minimal supervision to analyze data and other information to help drive the organizations managed care payor contracting strategy. Serves as the primary payor business intelligence expert for the managed care team and the broader organization. Develops, owns, and drives managed care reporting and intelligence for the organization.
Specific duties include, but are not limited to:
Support payer negotiations by gathering data from various departments to develop payor scorecards, evaluating current contract performance relative to expected payments, performing financial impact analysis of current and proposed payor contracts, interfacing with finance, operations or other departments as needed to gather and analyze service cost relative to current and proposed contract terms, recommending strategies to maximize contract value, interpreting various contract payment methodologies and successfully developing impactful financial models, and building and maintaining regular payor reporting by market.
Prepare various ad-hoc analyses and presentations by extracting data leveraging Tableau, SQL query language, Imagine, or other data systems as necessary.
Assist revenue cycle as needed to understand contractual pricing, including updating and modeling of rates and fee schedules into billing system, identifying gaps in radiopharmaceutical coverage by state Medicaid agencies and communicating coverage, and assisting with gathering updated or new payor fee schedules.
Evaluate chargemasters and self-pay pricing and recommends pricing strategies to maintain market competitive pricing.
Identify Medicare coverage and payment issues and work with the MACs as needed to resolve.
Position Requirements:
Bachelor’s Degree in Business, Finance, Engineering, Healthcare Administration, or other mathematical area of study or equivalent experience.
Excellent analytic, math and statistical skills. Ability to identify errors in the data and the knowledge of how to correct the errors.
Demonstrated experience and proficiency with Excel. Ability to troubleshoot and correct incorrect formula calculations and think critically about results and underlying assumptions.
An ability to write basic SQL code to perform data pulls or an ability to learn to write basic SQL code.
Excellent written and verbal communication skills. Ability to write and present effectively, adjust message to fit the audience and deliver a persuasive message.
Must be self –motivated, reliable and capable of working independently as well as part of a team.
Excellent problem-solving skills with the ability to hypothesize, test hypotheses, and draw valid conclusions by applying sound judgement in making decisions.
Extensive knowledge of the Microsoft office suite of products.
20% Travel may be required.
Preferred:
Previous experience in managed care, finance, or health care business office operations.
Knowledge and understanding of Payor, Provider, Medicare, and Medicaid finance components including budget, charge structure, reimbursement formulas and healthcare finance.
Demonstrated experience and proficiency in building Tableau reports.
Physical Requirements:
Standard office environment and may be exposed to environmental hazards such as exposure to noise, and travel
More than 50% of the time:
Sit, stand, and walk.
Repetitive movement of hands, arms and legs.
See, speak and hear to be able to communicate with patients.
Less than 50% of the time:
Stoop, kneel or crawl.
Climb and balance.
Carry and lift 10-20 lbs.
Residents living in CA, NY, Jersey City, NJ, WA and CO click here (http://drive.google.com/file/d/1LLdeY8zGifginLNDw7SxvqseqfeSOyp1/view?usp=sharing) to view pay range information.
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Akumin Operating Corp. and its divisions are an equal opportunity employer and we believe in strength through diversity. All qualified applicants will receive consideration for employment without regard to, among other things, age, race, religion, color, national origin, sex, sexual orientation, gender identity & expression, status as a protected veteran, or disability.