Warbird Healthcare Advisors has an immediate opportunity for an experienced interim Senior Managed Care Analyst.
The Interim Managed Care Analyst is responsible for negotiating contracts with managed care companies/health plans and providing advanced analytics to meet the strategic goals for financial performance of these contracts.
Key Responsibilities * Monitor contract performance based on an overall review of payer mix and payer performance to ensure meeting strategic goals on an annual basis and as needed.
* Project contract performance based on modeling of actual and representative samples.
* Analyze historical patient utilization data to determine both the statistical importance and the benefit of continuing a given contract.
* Review performance for all provider entities to the extent data is available.
* Assist with budget and long-range planning processes and complete annual surveys.
* Successfully negotiate language and rates for contracts and amendments on behalf of the health system * Develop payment rate structures that are appropriate to the provider type * Prepare and plan for annual negotiations, including review of contract performance and development of contract language to ensure it remains in compliance with current standards * Evaluate and develop hospital, physician and ambulatory surgery rate proposals and is familiar with various reimbursement methodologies.
* Develop, maintain and provide regular reporting on financial performance of the contracts for contract monitoring, budget and long-range planning, in support of revenue integrity efforts and for contract department performance and accountability review.
Requirements * Bachelor's degree in Healthcare Administration, Finance or related field * Minimum five (5) years of analysis in financial, reimbursement modeling or healthcare data or managed care negotiations with a healthcare organization, provider group or health plan/payer * Experience with Axiom Contract Management * Strong analytical and critical thinking skills to analyze large data sets.