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All the benefits and perks you need for you and your family:

Benefits from Day One

Career Development

Whole Person Wellbeing Resources

Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better.

**Shift** : Monday- Friday Full time 8am-5pm

**Job Location** : Altamonte Springs, FL

The role you will contribute:

The Managed Care Analyst applies technical, analytical, and problem-solving skills to provide solutions/improvements within the department. Responsible for completing financial and/or operational analysis of contracts, developing and tracking key performance indicators, financial modelling comparative analysis and bench marking. This person demonstrates competences in decision support and reporting through converting raw data into useful and actionable information. This person is responsible for compiling and analyzing data as well as for creating meaningful applications to support executive decision making. Character traits include: strong work ethic, trainability, communicative, team player all with a positive "can do" attitude. Intermediate Excel skills required.

The value you will bring to the team:

Reimbursement

+ Supports Managed Care leadership in financial modeling.

+ Basic knowledge of contractual language as it relates to reimbursement methodologies

Applies basic understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10, CPT, HCPCS II, DRG and revenue codes

+ Demonstrates knowledge of various reimbursement methodologies including, Per Diem, DRG, fee schedules, and percent of charge

+ Demonstrates knowledge of commercial payers for modeling and analyzing contract proposals

Contract Compliance

Performs analytical and planning functions in support of Managed Care decision making

Participates in the annual Managed Care revenue budget process

Utilizes a variety of software applications and data sources to produce the Managed Care Suite, DAA reports, other standard reporting, and adhoc reports

Evaluates actual contract performance against expected; analyzes data to distinguish patterns and recognize trends in contract performance

Innovation

+ Supports Senior Managed Care Analyst in timely and efficiently completing financial analyses related to Managed Care net revenue.

+ Completes multiple projects in a fast-paced environment within timeframes outlined in the department policies and as specified by Leadership

+ Adapts to new situations and changing priorities to accomplish project deadlines and department goals

+ Demonstrates strong project management and organizational skills by maintaining up-to-date project lists to assist in setting appropriate project priorities

Support

+ Applies technical expertise in the development of models and decision support information

+ Assures the application of appropriate standards of data analysis and that all analytics are quality checked

+ Develop an understanding of reimbursement methodologies and their impact on internal systems and other departments

+ Fully documents the process required to replicate any analytic process undertaken

+ Contributes to the overall completion of the work product in group project situations

+ Maintains and utilizes available resources to ensure work is completed accurately and timely

+ Professionalism

+ Displays a willingness to grow and develop skills required to perform his/her job duties

+ Takes the initiative to seek out education and training to stay informed of changes in the field of managed care

+ Participates in meetings as assigned or requested

+ Communicates problems and recommends solutions to Finance Manager

+ Adheres to applicable internal policies, procedures, and guidelines as set forth by Adventist Health Systems, its associated hospitals, physician groups, PHOs and ancillaries during the execution of assigned duties

+ Abides by all applicable rules, regulations, and laws prescribed by any authoritative governing body such as the State of Florida, AHCA, etc.

+ Does not interfere with the ability of co-workers to complete their duties

Position Focus:

Supports professional billing (PB) underpayments analysis, providing Physician Enterprise (PE) leadership with actionable insights to promote net revenue uplift. This role is responsible for identifying underpayments trends within and across AdventHealth PE divisions by region, service line, payer, and other guiding criteria. This role collaborates with Managed Care, feeding insights from PB underpayments analysis and trends across the Physician Enterprise to facilitate contract review and potential renegotiations.

The expertise and experiences you'll need to succeed:

Associate Degree

1 Work Experience

Microsoft Office (Excel PowerPoint, Word, Outlook, Visio, etc.)

Excellent verbal and written communication skills

Excellent problem-solving skills

Healthcare information systems (PCON, Cerner, Soarian)

Business Intelligence Software (Qlikview, Tableau, SAP, etc.)

Data warehousing tools (SQL Server, etc.)

Microsoft Visual Basic/Access

Financial Reporting and Analysis

Preferred Qualifications:

Bachelor's Degree

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

**Category:** Managed Care

**Organization:** AdventHealth Corporate

**Schedule:** Full-time

**Shift:** 1 - Day

**Req ID:** 25041462

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.