MANAGED CARE CONTRACT ANALYST

H. Lee Moffitt Cancer Center

Tampa, FL

Job posting number: #7110804 (Ref:hlj_40432)

Posted: September 16, 2022

Application Deadline: Open Until Filled

Job Description

Position Highlights:

 

The Managed Care Contract Analyst is responsible for timely, accurate system implementation of managed care contract rates including the tracking of rate changes and the loading, testing and evaluation of assigned contracts. The Managed Care Contract Analyst will also provide Leadership with periodic analysis and reports while maintaining quality and accuracy levels. This position requires extensive knowledge of both commercial and governmental payer reimbursement methodologies for loading, modeling and analyzing hospital, physician and transplant contracts.

 

Ideal Candidate:

 

  • Experience working with healthcare or insurance information systems (i.e. Cerner, Soarian**, Epic, PMMC)

 

  • Functional experience with Cerner Soarian Financials, PMMC CPRO/PPRO, or other Healthcare Financial Services systems.

 

Responsibilities:

 

  • Maintains contract management module functionality in the current systems, including but not limited to PMMC and Soarian.
  • Documents rate update process to ensure history of changes is available for internal use and external auditors.
  • Track and prepare for contract rate updates.
  • Prepare rate files for loading
  • Assesses how contracts will need to be modeled in current systems and how the system will process claims under negotiated terms.
  • Serves as process and content expert by demonstrating a thorough understanding of reimbursement methodologies and their impact on internal systems and other departments.

 

Credentials and Qualifications:

 

  • Bachelor’s Degree in Computer Science or health care related field.
  • Five (5) years of managed care contract implementation, and/or revenue cycle configuration and system support.

     - OR - 

*Associate’s degree with an additional two (2) years of experience with additional relevant managed care or healthcare revenue cycle operations related experience plus the five (5) years (for a total of 7 years) noted above.

 

Preferred:

  • **Soarian experience


Mission To create a Moffitt culture of diversity, equity, and inclusion as we strive to contribute to the prevention and cure of cancer. Vision To advance and accelerate a culture of access, equity, and inclusion. Diversity is a priority at Moffitt and is meant "to promote a culture of diversity and inclusion as we contribute to the prevention and cure of cancer." The Enterprise Equity Department focuses its efforts on eliminating those obstacles to an individual’s ability to exist within their personal comfort zone at the cancer center. Everyone is important to meeting this priority. Addressing and responding to diversity and inclusion fosters an environment where mutual respect for diverse cultures, communication styles, languages, customs, beliefs, values, traditions, experiences and other ways in which we identify ourselves, is the expectation.


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