Contract Analyst (Managed care)

Position Summary

We have an exciting opportunity to join our team as a Contract Analyst. In this role, the successful candidate is responsible for organizing and reviewing financial and utilization data and hospital billing data. This position is responsible for creating and analyzing profit and loss reports and other managed care reports from the cost accounting system. The incumbent will create managed care reports with detailed financial utilization data from other data sources. Additional responsibilities include reviewing all managed care contracts and addressing changes that impact these contracts, validation of contract compliance and other provisions of managed care.

Job Responsibilities

• Demonstrates knowledge of the organizations Core Values and incorporates them into the performance of duties.
• Organizes and reviews financial and utilization data, including insurer claims, eligibility, hospital billing data, payors physician fee schedules and Medicare RBRVS fee schedule.
• Reviews all managed care contracts; provides analytical support regarding changes impacting contracts, validation of contract compliance and other provisions of managed care.
• Uses EPSI reporting capability of the hospital decision support system to create managed care reports and to generate and analyze profit and loss reports on individual contracts.
• Uses Business objects to run detailed charge level data to accurately model contracts during rate negotiations or identify underpayments issues.
• Affords assistance to Hospital Finance Department to support financial management and evaluation of fee for service hospital contract and identify methods for improving report efficiency. As well as the FGP and other Hospital department ad hoc reporting.
• Maintains ongoing claims resolution activities and other practice or hospital service issues that impact reimbursement.
• Provides log-in access to payor websites by request.
• Affords assistance to Managed Care analytics with Contract modeling on a payor by payor basis.
• Performs tasks related to pricing transparency and other government regulatory requirements.
• Reviews and identifies yearly CPT coding changes and impact on current contracts.

Minimum Qualifications

• To qualify you must have a Bachelors degree in Business Administration or relevant discipline and 1-2 years relevant experience or an equivalent combination of education and experience.
• Proficiency using relational databases, database concepts and software applications; must have MS Access and Excel knowledge.
• Excellent interpersonal and presentation skills.
• Knowledge of healthcare terms and reimbursement methodologies.
• Strong analytical and problem solving skills.

Preferred Qualifications

• Familiarity with Crystal/EPSi reporting and EPIC.
• Qualified candidates must be able to effectively communicate with all levels of the organization.

Benefits

NYU Langone Health provides a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care.

Salary Range

The salary range for the role is $70,481.60 - $85,000 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need.