Interim Managed Care Analyst

Warbird Healthcare Advisors has an immediate opportunity for an experienced interim Senior Managed Care Analyst. The Interim Managed Care Analyst is responsible for negotiating contracts with managed care companies/health plans and providing advanced analytics to meet the strategic goals for financial performance of these contracts.

Key Responsibilities

• Monitor contract performance based on an overall review of payer mix and payer performance to ensure meeting strategic goals on an annual basis and as needed.
• Project contract performance based on modeling of actual and representative samples.
• Analyze historical patient utilization data to determine both the statistical importance and the benefit of continuing a given contract.
• Review performance for all provider entities to the extent data is available.
• Assist with budget and long-range planning processes and complete annual surveys.
• Successfully negotiate language and rates for contracts and amendments on behalf of the health system
• Develop payment rate structures that are appropriate to the provider type
• Prepare and plan for annual negotiations, including review of contract performance and development of contract language to ensure it remains in compliance with current standards
• Evaluate and develop hospital, physician and ambulatory surgery rate proposals and is familiar with various reimbursement methodologies. 
• Develop, maintain and provide regular reporting on financial performance of the contracts for contract monitoring, budget and long-range planning, in support of revenue integrity efforts and for contract department performance and accountability review.

Requirements

• Bachelor’s degree in Healthcare Administration, Finance or related field
• Minimum five (5) years of analysis in financial, reimbursement modeling or healthcare data or managed care negotiations with a healthcare organization, provider group or health plan/payer
• Experience with Axiom Contract Management
• Strong analytical and critical thinking skills to analyze large data sets.