Contract and Data Analyst (Managed Care)

Description Job Summary: Responsible for the analysis and negotiation of contracts, including monitoring existing contracts for payment compliance. This role involves communicating and resolving contract issues both internally and externally, as well as contributing to health system and individual contract negotiation strategies. The role also requires developing and building contract projection models (EPIC) essential to negotiation outcomes for the health system. Job Responsibilities: • Analyze contracts and communicate their operational impact to appropriate health system contacts. • Develop models, conduct analysis, and monitor the financial performance of existing and proposed contracts. • Monitor contract performance and compliance to ensure they meet expected levels by auditing financials and negotiating with payors for any money due. • Review and negotiate language in the contracting negotiation processes. • Develop, produce, and maintain data sets required for contract analysis. • Develop and maintain departmental processes to manage contracts. • Resolve contractual disputes with payors by collaborating with various health system entities and all related parties. • Analyze, develop, and test contract projection models within Epic essential to negotiation outcomes for both physician and hospital contracts/reimbursement. • Build programming and perform ongoing analysis to maintain the integrity of financial expectations of managed care contracts within the Epic system. • Resolve programming issues related to rate and revenue codes operations to maximize revenue potential for both physician and hospital contracts/reimbursement. • Ensure through Epic testing that the build is developed and performing correctly in collaboration with the Epic team to enhance contract modeling within Epic. • Perform other related duties as assigned to fulfill department responsibilities. Decision Making: Involves carrying out non-routine procedures under constantly changing conditions, following general instructions from a supervisor. Working Relationships: • Coordinate activities of others (does not supervise). • Work with internal customers via telephone or face-to-face interaction. • Work with external customers via telephone or face-to-face interaction. • Collaborate with other healthcare professionals and staff. • Frequently interact with individuals at Director level or above. Skills Required Skills & Experience: • Three (3) - four (4) years of related experience. • Experience with health plan insurance contracting and reimbursement for providers and facilities. • Ability to complete Epic certification and maintain certification in assigned application modules(s). • Ability to work independently and within a team across multiple disciplines. • Ability to establish and meet work schedules within limited time frames and under tight deadlines. • Analytical ability to solve both business and technical problems. • Working knowledge of Microsoft Excel, Word, Power BI, and Access. • Excellent interpersonal, written, and oral communication skills. • Attention to detail in the analysis and examination of complex information. Preferred Skills & Experience: • Experience with Microsoft Access, data warehouse applications, contract negotiations, contract financial modeling, contract language interpretation, and EPIC. Education Required Education: • Bachelor's degree in business or related field. Required Certifications & Licensure: • Obtain and maintain Epic certification in assigned application modules(s).