Introduction to Johns Hopkins Medicine
Join the esteemed team at Johns Hopkins Medicine as a Managed Care Analyst, where you will play a pivotal role in driving the success of our managed care contracts and fee schedules. As a leader in the healthcare industry, we are committed to providing exceptional patient care and innovative solutions. Our dynamic team is dedicated to excellence, and we are seeking a skilled and motivated individual to join our ranks. This remote position offers the freedom and flexibility to work from the comfort of your own home, with a competitive salary and comprehensive benefits package.
Job Summary
The Managed Care Analyst is responsible for the loading, modeling, support, and maintenance of managed care contracts and fee schedules within our contract management system. This includes contracts for all Health Systems entities, such as facility, professional, home care, infusion, pharmacy, and more. The successful candidate will provide key support for the implementation of new and upgraded systems/releases or new/revised operational procedures, as well as model, support, and operationalize risk-based contracting methodologies and global transplant agreements.
Key Responsibilities
- Accurately load and maintain all fee schedule and contract terms into the contract management system to ensure patient care and billing integrity.
- Assist with the resolution of payment discrepancies and thoroughly test and validate loaded contracts to maximize patient care and revenue cycle needs.
- Complete prospective modeling of proposed contracts, scenarios, and other changes potentially impacting reimbursement to support day-to-day operations and contract negotiations.
- Proactively review contract performance, identify improvement opportunities, and model impact for Managed Care review to inspire enhanced continuous improvement.
- Generate periodic standard reports and surveys in accordance with the established schedule to stay abreast of market trends.
- Analyze, compare, and determine the financial impact of Medicare/Medicaid/TriCare and commercial fee schedule changes, utilizing data to develop "what-if" scenarios to support managed care contract negotiations.
Qualifications and Requirements
To be successful in this role, you will need:
- A Bachelor's degree in Business, Accounting, Finance, Health Care Management, or an associated field of study.
- Licensure/Certification: Required to complete training and become certified in EPIC application modules, including Resolute Hospital Billing, Expected Reimbursement, Contracts Administration, and Resolute Professional Billing Reimbursement Contracts.
- At least 3 years of experience working in a decision support or financial analysis position with responsibility in a managed care healthcare provider environment.
- Computer skills with proficient knowledge of spreadsheet/graphics software, presentation software, database software, and report writer software.
- A working knowledge and understanding of managed health care contracts, as well as experience with contract modeling and contract management systems.
- Strong financial analysis skills and project management skills.
Essential Skills and Competencies
The ideal candidate will possess:
- Excellent analytical and problem-solving skills, with the ability to interpret complex data and develop creative solutions.
- Strong communication and interpersonal skills, with the ability to effectively collaborate with cross-functional teams.
- Proficiency in EPIC application modules, including Resolute Hospital Billing and Resolute Professional Billing.
- Experience with contract management systems and risk-based contracting methodologies.
- Strong project management skills, with the ability to prioritize tasks and manage multiple projects simultaneously.
Career Growth Opportunities and Learning Benefits
At Johns Hopkins Medicine, we are committed to the growth and development of our employees. As a Managed Care Analyst, you will have access to:
- Comprehensive training and certification programs to enhance your skills and knowledge.
- Opportunities for career advancement and professional growth within the organization.
- A dynamic and supportive work environment that encourages collaboration and innovation.
- Access to cutting-edge technology and systems, including EPIC application modules.
Work Environment and Company Culture
Johns Hopkins Medicine is a leader in the healthcare industry, with a strong commitment to excellence and innovation. Our company culture is built on the values of:
- Respect and dignity for all patients, visitors, and staff members.
- A commitment to diversity, equity, and inclusion.
- A focus on quality and patient safety.
- A supportive and collaborative work environment.
Compensation, Perks, and Benefits
We offer a competitive salary and comprehensive benefits package, including:
- Affordable healthcare options.
- Paid Time Off (PTO) and company-paid holidays.
- Tuition Assistance programs.
- Life and disability insurance.
- Opportunities for career development and growth.
- Employee discount programs for travel, tickets, dining, and more.
Conclusion
If you are a motivated and skilled professional looking for a challenging and rewarding role, we encourage you to apply for the Managed Care Analyst position. With a competitive salary, comprehensive benefits package, and opportunities for career growth and development, this is an exceptional opportunity to join a leader in the healthcare industry. Apply now and take the first step towards a fulfilling and successful career with Johns Hopkins Medicine.
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