Job Information
UNIVERSITY OF TEXAS AT AUSTIN Managed Care Analyst, UT Health Austin, Dell Medical School in Austin, Texas
Leads modeling of commercial and government payment methodologies for all types of healthcare services: physician, ambulatory and hospital etc.Transforms data into analytical insights, to inform decisions for the Managed Care, Revenue Cycle and Executive stakeholders.Effectively communicates analysis to be consumed by department and executive leadership.Demonstrates expert knowledge of both commercial and governmental payers for modeling and analyzing contract proposals with a variety of reimbursement methodologies: fee schedules, case rates, DRG, stop loss and other contract terms.Leverages physician (such as Experian MPV) and hospital (such as FinThrive) claim modeling systems for enhanced payer contract analytics.Continuously learns and adapts to a constantly changing reimbursement environment.Completes extensive and complex financial and operational analyses, modeling of managed care contracts and proposals, analyze fee schedules, revenue cycle KPIs, and determine contract performance and compliance.Performs analysis of claims data files to identify global denial and payment (over/underpayment) trends with payersExtracts, analyzes, and synthesizes data from various sources to identify risks and opportunities.Maximize the use of EMR reporting capabilities related to managed care and revenue cycle to inform and enhance decision making.Represent department needs as it relates to EMR system maintenance and upgrades.Additional Duties as assigned.