Managed Care Analytics Specialist

Professional Lawrence, Kansas


Description

Something special starts here.

You can’t define it, but you know it when you see it: the difference between an average life and the good life. When your cup is full – with joy, purpose and lifelong health – it shows. At LMH Health, we are all about healthy people, healthy communities and healthy futures, and that makes us your destination for an exceptional career. From flexible, work-life harmony to competitive pay and great advancement potential, find everything you’re looking for at LMH Health.

You'll find everything you’re looking for at LMH Health:

  • Join a team that cares about the community
  • Tuition reimbursement to support continuing education
  • Professional development and recognition
  • Excellent Benefits


We’re looking for you.

Oversee the Managed Care hospital and professional billing analytics including financial interpretation of contracts terms, contract modeling, financial analyses, EPIC contract build, audit and maintenance and identification of revenue enhancing opportunities. Develop alternative financial proposals that are within the budget parameters, based on analysis and modeling of contract performance by developing and preparing revised models using sound rationale, and present recommendations to Managed Care leadership. 

Responsibilities: 

  • Develop and maintain collaborative relations with the hospital and LMH Health provider and operations team.
  • Gather and interpret data from a variety of sources to provide accurate and complex data analysis supporting payer contract negotiations.
  • With a solid knowledge of healthcare revenue cycle processes and information, be able to work with all levels of healthcare professionals (both clinical and non-clinical), and interface with all payers to advance issue resolutions and strategic initiatives.
  • Perform financial analysis responsibilities such as developing new business pro formas, service line program profitability analysis, total cost of care claims analysis, and forecasting work.
  • Complete financial impact analysis of hospital and professional contract negotiations, including modeling of contract proposals, reporting of contract proposal impact, performance and quantifying financial impact of these proposals for future year(s) and developing alternative proposals within the budget parameters.
  • Present analysis and recommendations to leadership after prepare multiple analyses and presentations by extracting data from systems including relational databases utilizing strong expertise in Excel.
  • Evaluates the need to create new or modify existing ad hoc and/or customized reports. 
  • Analyze contracts and prepare all supporting schedules necessary This includes but not limited to: reviewing all new contracts/amendments, meeting with Patient Financial Services staff to review changes, communicating with the payors to receive all updates on current basis, researching and downloading data form payor sites, analyzing and comparing new fee schedules to the prior fee schedules, preparing all uploads, validating input and updating reimbursement contracts.
  • Audit all Managed Care contracts and amendments as received to ensure that all contract are current and calculating correctly.
  • Proactively model all changes to fee schedules to determine the financial impact on revenue and communicate with leadership.

Qualifications:

Required: 

  • B.S. or B.A degree in business, with an emphasis in statistics, computer science, mathematics, informatics, public health or another field requiring extensive data analysis required.
  • 2+ years prior healthcare experience related to managed care contracting or payer relations data analysis.
  • Experience in health care data analysis and visualization methods.
  • Demonstrated experience in health care analytics, statistical analysis or regulatory reporting may be considered in lieu of degree.

Our Cultural Beliefs

  • Patient First. We consider the patient first in everything we do.
  • Better Together. We actively strive to be a diverse LMH Health team that works together to achieve excellence.
  • Listen/Speak Up. We embrace a diverse culture of open, respectful, well-intended communication where we listen, share, and value ideas to create equitable solutions.
  • Innovate! We actively explore new ideas and approach change with agility and an open mind.
  • Own It/Solve It. We hold ourselves accountable for our actions and we collaborate for solutions.
  • In Joy. We create a workplace that is both fun and meaningful.

At LMH Health, we value inclusion and diversity. We are an equal opportunity employer and encourage all to apply. Employment is decided on the basis of experience and qualifications that meet the business need.