Managed Care Contracting Analyst II

Are you ready to make a strategic impact in healthcare? As a Managed Care Contracting Analyst II, you’ll be at the forefront of shaping financial and operational success for St. Jude. This pivotal role involves evaluating, negotiating, implementing, and monitoring complex contract rates and terms across a wide spectrum of services—including facility, professional, pharmacy, home infusion, and home health.

You’ll be the trusted liaison, bridging internal departments and external agencies to ensure seamless contracting processes and effective single patient agreements.

This is a hybrid role, with two days on site.

Job Responsibilities:

• Evaluate, analyze, negotiate, implement and monitor contracts for facility and professional services provided by St. Jude in accordance with established contract parameters and timeframes.
• Manage analysis of all current and future payor contract terms.
• Conduct contract language and rate negotiations with payors for facility and professional services in accordance with department contracting requirements.
• Act as a primary facilitator for the contract management modeling system to ensure contracts are loaded accurately as per timelines.
• Prepare monthly and quarterly reports on contract performance with analysis on expected reimbursement.
• Train and guide team members on systems, processes, and tools within own area of expertise; address simple escalations/deviations.
• Perform other duties as assigned to meet the goals and objectives of the department and institution.
• Maintains regular and predictable attendance.

Minimum Education and/or Training:

• Bachelor’s degree (e.g., Business Administration, Information Services) or any health related field of study required.

Minimum Experience:

• Minimum Requirement: 2+ years of experience (in physician credentialing, medical staff support and/or enrollment activities, preferred).
• Prior experience in healthcare contracting and or medical billing/reimbursements strongly preferred.
• Strong experience with managed care contracting preferred.
• Experience working with internal and external teams.
• Experience with the financial aspects of various payment mechanisms, especially within managed care.
• Proven performance in earlier role.
• EPIC experience preferred.
• Prior experience conducting and/or overseeing all enrollment activities for the hospital, pharmacy and home infusion preferred.

Certification

• Professional certification (e.g., RN/RHIA/CPC/CPCS/NAMSS) preferred

Compensation

In recognition of certain U.S. state and municipal pay transparency laws, St. Jude is including a reasonable estimate of the compensation range for this role. This is an estimate offered in good faith and a specific salary offer takes into account factors that are considered in making compensation decisions including but not limited to skill sets, experience and training, licensure and certifications, and other business and organizational needs. It is not typical for an individual to be hired at or near the top of the salary range and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current salary range is $70,720 - $126,880 per year for the role of Managed Care Contracting Analyst II.

Explore our exceptional benefits!

St. Jude is an Equal Opportunity Employer

No Search Firms

St. Jude Children's Research Hospital does not accept unsolicited assistance from search firms for employment opportunities. Please do not call or email. All resumes submitted by search firms to any employee or other representative at St. Jude via email, the internet or in any form and/or method without a valid written search agreement in place and approved by HR will result in no fee being paid in the event the candidate is hired by St. Jude.