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Location: Lewes, Delaware
Internal Number: 8388
The Contract Management Analyst is responsible for preparing financial and risk analysis for payer contract management and contract negotiations. Designs models and performs ad hoc analysis for the purpose of understanding the historical and future performance of existing contracts; synthesizes and reports data to management. Assists in negotiating contracts and maintaining contract management software. Responsible for maintaining relationships with payers and communicating directly with payer representatives to report and resolve payment discrepancies or denial issues related to contract terms. Provides advice on how to proceed in complex cases when contract guidelines and language need clarification.
Healthcare analytical experience, including at least three years progressively responsible work experience in healthcare finance, required. Experience working with cross-functional departments to research and resolve issues using innovative solutions preferred Minimum of three years of data or financial analytical experience required. Healthcare analytical experience, including at least three years progressively responsible work experience in healthcare finance, required. Experience working with cross-functional departments to research and resolve issues using innovative solutions preferred. Five years of data or financial analytical experience in a Healthcare SettingStrong computer application skills and working knowledge of database management and systems. Excellent analytical, organizational, and computer skills. Proven strong communications skills. Ability to interact with hospital leadership and peers in a professional and courteous manner.Knowledge of managed care reimbursement methods, medical terminology, medical and healthcare billing and collections.
Perform a wide range of high-level and detailed analytical functions for contract management and negotiation, including but not limited to financial performance, reimbursement comparisons, risk analyses, and quality program assessments.
Create and communicate complex financial and risk models for the purposes of evaluating historical and future performance of existing contracts.
Develop and produce financial reports on a periodic and ad hoc basis for hospital management.
Assist in negotiating contracts, maintaining contract management software, analyzing financial impact, and monitoring payments for compliance.
Support the managed care division's initiatives through analysis and performs forecasts on the impact of reimbursement terms during contract negotiation process.
Assist in the preparation, processing, research, and analysis of Medicare, Medicaid, and managed care cost reports to ensure the accuracy of claim payments.
Assist in the preparation of third-party contractual allowances for inclusion in financial statements.
Review managed care contracts to determine appropriate application of rates, provisions, and terms.
Interact with various hospital stakeholders, department heads, and physicians to educate staff related to managed care reimbursement models.
Work with departments to develop and maintain specific payment arrangements for unique services.
Collaborate with legal department to develop contract language.
Identify potential underpayment trends through comparison of managed care contracts to actual reimbursement information via contract management technology.
Investigate third-party payer policies and contracts to verify accuracy of underpayment variances according to published payer guidelines.
Provide documentation for third-party payer audits.
Provide reimbursement information and analysis to other hospital departments.
Maintain knowledge of reimbursement regulation.
Competencies and skills:
* Clear Communication Skills Both Written And Verbal
* Knowledge Of Basic Computer Programs
* Able To Keep Confidential Information Regarding Patients, Team Members
* Able To Withstand Crisis Situations
* Has Skills To Provides Customer Service To Patients, Team Members And Visitors
* Experience Or Completed Courses In Coding
* Bachelor's Degree in related field
Education equivalent experience:
* OR FINANCE OR BUSINESS
Location: Hospital-Main Campus
Shift : 8am-4:30pm Monday - Friday
Work Status: Full TimeAbout Beebe HealthcareBeebe Healthcare serves the Sussex County community with a medical center located in beautiful, historic Lewes, Delaware, and convenient outpatient locations throughout the county. Founded in 1916 by two physician brothers, Drs. James Beebe and Richard C. Beebe, the medical center in Lewes is a 210-licensed-bed, not-for-profit seaside community hospital. Beebe's specialized service lines include cardiac and vascular, surgical services, oncology, women's health, and orthopaedic services. Beebe offers an array of inpatient, outpatient, emergency, and diagnostic services. Beebe's five satellite campuses offer imaging, physical rehabilitation, and lab services, as well as walk-in care centers. In addition, Beebe offers Wound Healing & Hyperbaric Medicine and Diabetes Management & Medical Nutrition Therapy. With a mission to serve the community, Beebe also offers many free screenings and outreach programs through its Population Health Department; and advanced medical care for those who are recuperating at home through Beebe Home Care Services. Beebe is also training the next generation of nurses through the Margaret H. Rollins School of Nursing, located behind the Medical Cente...r in Lewes. Beebe's Medical Staff has grown tremendously since the early 1990s. Employed physicians through Beebe Medical Group and our affiliated physicians on Beebe's Medical Staff now serve patients from Milford to Millville in specialties including cardiac surgery, dermatology, endocrinology, family practice, gastroenterology, general surgery, internal medicine, pediatric neurology, and surgical oncology. Beebe is proud to offer quality care, close to home for the residents and visitors of Sussex County.Show moreShow lessMore Jobs from This Employerhttps://careers.qualityforum.org/jobs/18520851/contract-analyst-business-servicesLoading. Please wait.
1099 14th Street NW
Washington DC 20005