[Hiring] Sr. Managed Care Contract Analyst @Emerus

Role Description 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
• Contributing to annual budgeting and month-end close processes
• Providing support to Revenue Cycle and Revenue Recognition teams on payer-related issues and contract disputes
• 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 revenue.

Qualifications

• Bachelor’s degree in Finance, Accounting, Business Administration, or equivalent experience required
• Minimum of 3 years of healthcare 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 Microsoft Excel 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 mindset

Requirements

• Serve as the managed care liaison and subject matter expert for joint venture hospital partners, revenue cycle billing and collections teams, and finance department leaders
• Compile and analyze payer performance metrics for reporting to organizational leadership
• Maintain up-to-date managed care contract databases to streamline collections, support analysis, and share contract terms efficiently
• Assist the revenue cycle team by loading and maintaining current payer rates in an insured allowed/payment validation module
• Perform 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 current performance yields and evaluate new contract proposals
• Collaborate with the revenue cycle team to identify underpaid/overpaid claims and develop initiatives to secure accurate payments
• Provide managed care insights and contract modeling (e.g., rate escalators, charge master updates, new contract yields) to support the finance team’s annual budget process
• Assist the revenue recognition team during month-end close by offering managed care perspectives on key revenue-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

Benefits

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

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