All the benefits and perks you need for you and your family:
· Benefits from Day One
· Career Development
· Whole Person Wellbeing Resources
· Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Job Location: Hybrid - 3 days at the office
The role you’ll contribute:
The Managed Care Analyst applies technical, analytical, and problem-solving skills to provide solutions/improvements within the department.Responsible for completing financial and/or operational analysis of contracts, developing and tracking key performance indicators, financial modelling comparative analysis and bench marking. This person demonstrates competences in decision support and reporting through converting raw data into useful and actionable information.This person is responsible for compiling and analyzing data as well as for creating meaningful applications to support executive decision making. Character traits include: strong work ethic, trainability, communicative, team player all with a positive “can do” attitude. Intermediate Excel skills required.
The value you’ll bring to the team:
·Supports Managed Care leadership in financial modeling.
·Basic knowledge of contractual language as it relates to reimbursement methodologies
·Applies basic understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, CPT, HCPCS II, DRG and revenue codes
·Demonstrates knowledge of various reimbursement methodologies including, Per Diem, DRG, fee schedules, and percent of charge
·Demonstrates knowledge of commercial payers for modeling and analyzing contract proposals
·Performs analytical and planning functions in support of Managed Care decision making
·Participates in the annual Managed Care revenue budget process
·Utilizes a variety of software applications and data sources to produce the Managed Care Suite, DAA reports, other standard reporting, and adhoc reports
·Evaluates actual contract performance against expected; analyzes data to distinguish patterns and recognize trends in contract performance
·Supports Senior Managed Care Analyst in timely and efficiently completing financial analyses related to Managed Care net revenue.
·Completes multiple projects in a fast-paced environment within timeframes outlined in the department policies and as specified by Leadership
·Adapts to new situations and changing priorities to accomplish project deadlines and department goals
·Demonstrates strong project management and organizational skills by maintaining up-to-date project lists to assist in setting appropriate project priorities
·Applies technical expertise in the development of models and decision support information
·Assures the application of appropriate standards of data analysis and that all analytics are quality checked
·Develop an understanding of reimbursement methodologies and their impact on internal systems and other departments
·Fully documents the process required to replicate any analytic process undertaken
·Contributes to the overall completion of the work product in group project situations
·Maintains and utilizes available resources to ensure work is completed accurately and timely
·Displays a willingness to grow and develop skills required to perform his/her job duties
·Takes the initiative to seek out education and training to stay informed of changes in the field of managed care
·Participates in meetings as assigned or requested
·Communicates problems and recommends solutions to Finance Manager
·Adheres to applicable internal policies, procedures, and guidelines as set forth by Adventist Health Systems, its associated hospitals, physician groups, PHOs and ancillaries during the execution of assigned duties
·Abides by all applicable rules, regulations, and laws prescribed by any authoritative governing body such as the State of Florida, AHCA, etc.
·Does not interfere with the ability of co-workers to complete their duties
The expertise and experiences you’ll need to succeed:
KNOWLEDGE AND SKILLS REQUIRED:
·Microsoft Office (Excel PowerPoint, Word, Outlook, Visio, etc.)
·Excellent verbal and written communication skills
·Excellent problem-solving skills
Analytical, attention to detail, curious, open to learning
KNOWLEDGE AND SKILLS PREFERRED:
·Healthcare information systems (PCON, Cerner, Soarian)
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.