U

University of Texas at Austin

Public research university in Austin, TX

Managed Care Analyst

Corporate Finance & FP&AConfirmed live in the last 24 hours
Full-timeAustin, TX, USA$63.3k /yrIn-person

About the Job

Requirements

  • A Bachelor's degree in Data Science, Analytics, Health Administration, Public Health, Finance, or a related quantitative or healthcare discipline is required.
  • At least four years of experience in managed care analytics, healthcare finance, payer contracting, or a related field is required.
  • Advanced knowledge of commercial and government reimbursement, managed care contracting, fee schedules, revenue cycle management, and EMR software systems such as Epic is required.

Responsibilities

  • Model commercial and government payment methodologies for physician, ambulatory, and hospital services.
  • Analyze contract proposals using reimbursement methods such as fee schedules, diagnosis-related groups (DRG), case rates, and stop-loss.
  • Leverage tools such as Experian MPV and FinThrive for contract modeling.
  • Synthesize contract terms to support negotiation strategies.
  • Evaluate contract performance and compliance.
  • Extract and interpret data from electronic medical records (EMRs), such as Epic and Athena, and financial systems.
  • Develop dashboards and reports for Managed Care, Revenue Cycle, and Executive stakeholders.
  • Identify risks and opportunities in payer performance and reimbursement.
  • Synthesize complex datasets into actionable recommendations.
  • Support strategic initiatives with data-driven insights.
  • Monitor key performance indicators related to claims, denials, and payments.
  • Identify trends in overpayments, underpayments, and global denials.
  • Collaborate with Revenue Cycle teams to resolve payer issues.
  • Use EMR reporting capabilities to enhance decision-making.
  • Support compliance and audit readiness.
  • Prepare and present findings to department and executive leadership.
  • Translate complex analytics into clear, actionable insights.
  • Serve as a liaison between internal teams and external payers.
  • Participate in cross-functional meetings and payer summits.
  • Support education and training on managed care analytics.
  • Monitor changes in reimbursement models and payer policies.
  • Conduct market research on healthcare trends and regulations.
  • Attend professional development events and webinars.
  • Evaluate emerging technologies and analytics tools.
  • Represent department needs in EMR system maintenance and upgrades.
  • Collaborate with IT and vendor teams to optimize reporting tools.
  • Test and validate system changes related to managed care analytics.
  • Document system requirements and workflows.
  • Provide feedback for continuous improvement.

Desired Qualifications

  • A Master's degree in Health Administration, Public Health, Business, or Data Analytics, with at least seven years of experience in managed care analytics or contract negotiation, is preferred.
  • Experience in an academic medical center or large integrated health system is preferred.
  • Certified Professional in Healthcare Quality (CPHQ) is preferred.
  • Certified Health Data Analyst (CHDA) is preferred.
  • NCQA HEDIS Compliance Auditor (CHCAA) is preferred.
  • Project Management Professional (PMP) certification is preferred.

About the Company

University of Texas at Austin

Public research university in Austin, TX

University of Texas at Austin is a public research university in Austin, Texas. It offers undergraduate, graduate, and professional education across a broad range of fields.

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