Managed Care Senior Analyst in Santa Fe Springs, CA at Avanti Hospitals

Date Posted: 7/10/2019

Job Snapshot

Job Description

Central Business Office

Job Title: Managed Care Senior Analyst 

City: Santa Fe Springs / State: California    

Central Business Office

From 8:00 AM

To 4:30 PM

                                      


Job Description and Job Responsibilites

Job Summary:

The position of the Managed Care Analyst, Senior supports the CBO and senior management by preparing advanced reports and analysis from internal data sources. As a liaison with other departments, the MCA-S ensures that managed care reporting needs are being addressed and met. The MCA-S is an independent worker and performs the necessary collection and analysis of data to address questions from senior management and individuals outside the organization. Key traits of this position are: strong analytical skills, highly motivated, utilizes conventional and unconventional methods to solve problems and takes ownership of issues. This position supports the mission of the hospital through the provision of distinctive and compassionate care to our employees and patients.

Essential Functions:

Works closely with revenue cycle management to track and trend managed care plan performance including the development of payer “report cards”, completed with little to no direction from supervisor.

 Health plan data/reports are carefully reviewed and a detailed analysis is prepared, which identifies trends in revenue, collections and denials. 

Monthly reports and payments to contracted providers are prepared accurately and timely and include a thorough analysis of payment fluctuations. Inquiries from providers and leadership regarding payments and reports are addressed quickly and accurately. The report preparation and inquiries are handled with little to no direction from supervisor. 

By-health plan receivable aging and denial reports are prepared and thoroughly analyzed in accordance with established deadlines with minimal to no direction from supervisor. 

Collaborations with decision support department, health plans, corporate managed care, etc. to strategize and design databases and queries that are productive and achieve desired results.

 Presentations to senior leadership are thorough, yet succinct, clearly address issues and exhibit professionalism and tact.

 Proactively and independently identifies anomalies in data. Prepares and presents appropriate, actionable data and recommendations to leadership.

 Assists CBO with Month-End reporting to include validating expected reimbursement on all billed and unbilled accounts.

 Meet Month-End time frames given for Financial reporting.

 Assists CBO Director in facilitating standing meetings with payers to resolve issues.

 Other Duties as assigned

 




Job Requirements

Experience and Education:

Prefer minimum 5 years in Hospital, provider, managed care organizations, or other health care entity

Associates degree in Finance, Healthcare Administration, or related field expected; BA preferred

 

 

Job Requirements

Experience and Education:

Prefer minimum 5 years in Hospital, provider, managed care organizations, or other health care entity

Associates degree in Finance, Healthcare Administration, or related field expected; BA preferred