Note: The job is a remote job and is open to candidates in USA. HCA Healthcare, through its Parallon revenue cycle management organization, is seeking a Contract Analyst. The role models managed care contracts, translates contract terms into system models, performs financial and reimbursement analyses, and supports pricing decisions, contract negotiations, implementation, and ongoing maintenance.
Responsibilities
- Model managed care contracts using available modeling tools
- Ensure accurate discounts on patient accounts and proper reflection of expected net revenue
- Complete testing of contract models by service line and document accuracy in modeled results
- Perform prospective ("what-if") financial modeling to evaluate proposed managed care contract terms and assess their impact on reimbursement, profitability, trends, and other key financial metrics
- Develop and maintain contract models used to evaluate reimbursement methodologies, support managed care agreements, analyze financial impact, and ensure accurate implementation and ongoing maintenance of contract terms
- Translate contract language and reimbursement methodologies into accurate system models that support operational reimbursement and contract negotiations
- Accurately apply service descriptions, service rules, reimbursement logic, and modeling parameters to ensure contract integrity and consistency
- Perform quality assurance reviews of contract model changes related to rates, factors, and reimbursement methodologies to ensure modeling accuracy, consistency, and compliance with established standards
- Design, develop, and support ad-hoc analyses and reporting initiatives as assigned by leadership
- Utilize data mining and reporting tools to fulfill customer requests and support operational and strategic initiatives
- Monitor the progress of pricing analyses and contract modeling activities, keeping management informed of project status, risks, and outcomes
- Collaborate with Payer Contracting, Revenue Cycle, Finance, and operational stakeholders to resolve contract questions and provide analytical support during contract negotiations and implementation
- Develop responsive relationships with internal customers by providing timely, accurate analyses and maintaining a high level of customer service
- Participate in departmental training and professional development opportunities to enhance technical, analytical, and industry knowledge
- Contribute to continuous process improvement initiatives that increase modeling accuracy, operational efficiency, and reporting capabilities
- Demonstrate commitment to organizational Mission, Values, and Code of Conduct while producing high-quality, accurate work
Skills
- Bachelor's Degree or Undergraduate Degree Required. Equivalent work experience may substitute for education requirements
- Minimum 1+ years of related experience preferred
- Working knowledge of managed care contracting, reimbursement methodologies, and contract modeling preferred
- Experience with Microsoft Office, Excel, relational databases, reporting tools, and contract modeling applications preferred
Benefits
- Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
- Wellbeing support, including free counseling and referral services
- Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
- A 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
- Employee Stock Purchase Plan
- Flexible spending accounts
- Preferred banking partnerships
- Retirement readiness tools
- Rollover support and financial wellbeing counseling
- Tuition assistance
- Student loan assistance
- Certification support
- Dependent scholarships
- A partnership with Galen College of Nursing
- Fertility and family building benefits
- Adoption assistance
- Life insurance
- Supplemental health protection plans
- Auto and home insurance
- Legal counseling
- Identity theft protection
- Consumer discounts
Company Overview