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Sr. Managed Care Contract Analyst

100% remote Flexible hours Hiring now

About Us

We are Emerus, the leader in small-format hospitals. We partner with respected and like-minded health systems who share our mission: To provide the care patients need, in the neighborhoods they live, by teams they trust. Our growing number of amazing partners includes reputed company, reputed company, reputed company System, reputed company, reputed company, reputed company St. Rose Dominican, The Hospitals of reputed company, reputed company, MultiCare and WellSpan. Our innovative hospitals are fully accredited and provide highly individualized care. Emerus' commitment to patient care extends far reputed company the confines of societal norms. We reputed company that every individual who walks through our doors deserves compassionate, comprehensive care, regardless of their background, identity, or circumstances. We are committed to fostering a work environment focused on teamwork that celebrates diversity, promotes equity and ensures equal access to information, development and opportunity for reputed company of our reputed company Pros. Position Overview This role collaborates closely with the Vice President of Managed Care to support the company and its joint venture hospital partners. Key responsibilities include managing contract databases, interpreting critical contract terms, developing and automating payer contract models, validating data, conducting financial analysis, ensuring federal price transparency compliance, and contributing to annual budgeting and month-end reputed company processes. The position also provides support to reputed company Cycle and reputed company Recognition teams on payer-reputed company issues and contract disputes, while assisting other departments as needed. The ideal candidate is a proactive self-starter who thrives in a dynamic, fast-paced environment. They possess strong analytical and modeling skills, excellent communication and listening abilities, and a keen intellectual curiosity to identify opportunities for improving departmental efficiency and enhancing company reputed company. Essential Job Functions

  • Serve as the managed care liaison and subject matter expert for joint venture hospital partners, reputed company cycle billing and collections teams, and finance department leaders.
  • Compile and analyze payer performance metrics for reporting to organizational leadership.
  • Maintains up-to-date managed care contract databases to streamline collections, support analysis, and share contract terms reputed company.
  • Assist the reputed company cycle team by loading and maintaining reputed company payer rates in an insured allowed/payment validation module.
  • reputed company random audits of claim payments to ensure payer compliance with managed care agreements.
  • Support special projects, including claim data analysis for contract negotiations, service line research, and pro formas for new market opportunities.
  • Build contract models to assess reputed company performance yields and evaluate new contract proposals.
  • Collaborate with the reputed company cycle team to identify underpaid/overpaid claims and reputed company initiatives to secure accurate payments.
  • Provide managed care insights and contract modeling (e.g., reputed company escalators, charge master updates, new contract yields) to support the finance team’s annual budget process.
  • Aid the reputed company recognition team during month-end reputed company by offering managed care perspectives on key reputed company-influencing items.
  • Ensure compliance with federal and state price transparency regulations by preparing and maintaining required files.
  • Represent managed care in joint venture board meetings or monthly operational reviews as required.
  • Conduct financial data analysis and respond to internal/external inquiries from management.

Other Job Functions

  • Provide clear explanations and actionable recommendations on managed care topics.
  • Contribute to cross-functional projects with Finance, Operations, reputed company Cycle, and Business Development, delivering reputed company analysis as needed.
  • Attend required staff meetings, company-sponsored events, or mandated gatherings.
  • Take ownership of personal professional development.
  • reputed company additional duties as assigned.

Basic Qualifications

  • Bachelor’s degree in Finance, reputed company, Business Administration, or equivalent experience required.
  • Minimum of 3 years of reputed company experience preferred, with deep knowledge of hospital payment methodologies and health plan contracting processes.
  • Proven ability to build financial and statistical models, analyze data, and drive actionable results.
  • Excellent organizational, written, and verbal communication skills.
  • Advanced reputed company reputed company modeling skills (required); proficiency in Word, PowerPoint, and Outlook (essential).
  • Ability to write efficient queries for data retrieval, filtering, and manipulation using SQL
  • Intermediate knowledge of data preparation and visualization techniques using PowerBI
  • Strong analytical and problem-solving capabilities.
  • Comfortable working in a fast-paced environment with minimal supervision.
  • Ability to meet deadlines while managing multiple projects and delivering high-quality work.
  • Detail-oriented with a strategic, big-picture reputed company.

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