Senior Managed Care Analyst at Children’s National Hospital

Silver Spring, Maryland, United States -

Full Time

Start Date

Immediate

Expiry Date

04 Jan, 26

Salary

0.0

Posted On

06 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Analytical Skills, PC Skills, Financial Analysis, Utilization Analysis, Teamwork, Communication Skills, Organizational Skills, Presentation Skills, Health Care Experience, Contract Assessment, Report Development, Cost Analysis, Quality Assurance, Customer Service, Problem-solving, Cost Management

Industry

Biotechnology Research

Description

The Senior Managed Care Analyst will collect and analyze data on costs, charges and utilization to support negotiations with managed care companies. Will develop and implement appropriate tools to expedite effective evaluation and monitoring of managed care contract performance and service utilization. Minimum Education Bachelor's Degree Business, Accounting, Health Care Administration, Economics or Mathematics. (Required) Master's Degree (Preferred) Minimum Work Experience 3 years Relevant work experience in financial and/or utilization analysis. (Required) Required Skills/Knowledge Proven analytical skills including ability to make recommendations based on financial analyses. Superior PC skills including proficiency in word, spreadsheet analysis and database management. Experience with financial and utilization analysis. Ability to work in a team environment with other analysts, managers, and physicians. Strong communication and organizational skills. Proficiency in presentation of analytical results. Previous experience in health care is highly desirable, including experience with hospital/physician information and patient accounting information systems. Functional Accountabilities Contract Provisions Assessment Develop reports to assess existing contracts by type of service. Develop models to assess impact of alternative contract rates to support negotiations. Operational Issues Provide updated reports for inpatient and outpatient service categories. Complete ad hoc reports for individual payors as needed. Provide routine reports to monitor plan utilization and contract performance. Provide comprehensive reports for evaluation of FY results. Analyze Provide analysis of cost information using available cost tables. Safety Speak up when team members appear to exhibit unsafe behavior or performance Continuously validate and verify information needed for decision making or documentation Stop in the face of uncertainty and takes time to resolve the situation Demonstrate accurate, clear and timely verbal and written communication Actively promote safety for patients, families, visitors and co-workers Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance Organizational Accountabilities Quality Assurance Review rules and identify problem areas to assure expected payments are correct. Organizational Commitment/Identification Partner in the mission and upholds the core principles of the organization Committed to diversity and recognizes value of cultural ethnic differences Demonstrate personal and professional integrity Maintain confidentiality at all times Customer Service Anticipate and responds to customer needs; follows up until needs are met Teamwork/Communication Demonstrate collaborative and respectful behavior Partner with all team members to achieve goals Receptive to others’ ideas and opinions Performance Improvement/Problem-solving Contribute to a positive work environment Demonstrate flexibility and willingness to change Identify opportunities to improve clinical and administrative processes Make appropriate decisions, using sound judgment Cost Management/Financial Responsibility Use resources efficiently Search for less costly ways of doing things

Responsibilities

The Senior Managed Care Analyst will collect and analyze data on costs, charges, and utilization to support negotiations with managed care companies. They will develop and implement tools for evaluating and monitoring managed care contract performance and service utilization.