Note: The job is a remote job and is open to candidates in USA. HCA Healthcare is seeking a Contract Analyst to support managed care contract modeling and reimbursement analysis. The role evaluates payer terms, develops and tests contract models, performs financial analyses, supports pricing decisions and negotiations, and collaborates with contracting, finance, revenue cycle, and operational stakeholders.
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
- Work from Home position
- 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
- Savings and retirement resources, including 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
- Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
- Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts
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