Top 1961 Managed Care Analyst Jobs

Managed Care Analyst
MedOp Solutions —Hickory, NC
- Microsoft Access
- Research
- Mid-level
Quick Apply
8d
Managed Care Appeals Analyst
Elevate Patient Financial Solutions —Remote
- $23.00 - $28.28 an hour
- Full-time
- Remote
- Microsoft Word
- Surgery
- Writing skills
- Paid holidays
- Health insurance
Quick Apply
Associate Managed Care Analyst
Allegheny Health Network —Pennsylvania
- $34.29 - $54.25 an hour
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Finance
Managed Care Analyst
MD Anderson —Texas
- $77,500 - $116,500 a year
- Full-time
- Remote
- Customer service
- Finance
- Analysis skills
- AD&D insurance
- Paid holidays
Epic Tapestry Analyst (Managed Care Operations) - Remote
Cedars-Sinai —Beverly Hills, CA
- $96,324.80 - $139,672.00 a year
- 8 hour shift
- Hybrid work
- Computer Science
- Mid-level
- High school diploma or GED
Medicare Billing Analyst
Quest Diagnostics —Remote
- $40 an hour
- Contract
- Remote
- Mid-level
- High school diploma or GED
Quick Apply
Managed Care Analyst I
Desert Physicians Management LLC —Apple Valley, CA
- $23.00 - $27.60 an hour
- Full-time
- Hybrid work
- Microsoft Outlook
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Managed Care Analyst
Family HealthCare Network —Visalia, CA
- $69,807.05 - $111,691.28 a year
- Full-time
- Microsoft Word
- Computer literacy
- Basic math
- Paid training
Managed Care Analyst
White Plains Hospital —White Plains, NY
- $69,257 - $103,907 a year
- Full-time
- Microsoft Excel
- Hospital
- Mid-level
Managed Care Analyst - Capitation Revenue
Memorial Health Services —Fountain Valley, CA
- $38.36 - $55.61 an hour
- 8 hour shift
- Microsoft Excel
- Mid-level
- Finance
- Health insurance
Contract Analyst (Managed care)
NYU Langone Health —New York, NY
- $70,481.60 - $85,000.00 a year
- Online Application
- Microsoft Access
- Hospital
- Mid-level
- Wellness program
Value Based Care Analyst
South Florida Community Care Network LLC —Sunrise, FL
- $70,000 - $90,000 a year
- Hybrid work
- Background check
- Mid-level
- Office
Quick Apply
Payment Policy Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $58,320 - $115,830 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Mid-level
- 401(k)
Quick Apply
Billing Specialist
Pinnacle Home Care —Remote
- Full-time
- HIPAA
- Mid-level
- 3 years
- Referral program
Quick Apply
Staff AI Product Analyst, Product Management | USA, EST | Remote
Grafana Labs —Remote
- $162,275 - $194,730 a year
- Remote
- SQL
- Product management
- Senior level
Managed Services Analyst I
GHX —Atlanta, GA
- $18 - $22 an hour
- Remote
- Computer literacy
- High school diploma or GED
- Travel
- Health insurance
- Dental insurance
Quality Assurance Analyst
MetroPlus Health Plan —New York, NY
- $85,000 - $95,000 a year
- Full-time
- Remote
- Customer service
- Mid-level
- 3 years
Contract Analyst
TEXASCONNECT INC —Remote
- Full-time
- Remote
- Microsoft Access
- Customer service
- Computer literacy
Underpayment Analyst, Denials - Zero Balance (REMOTE)
EnableComp —Remote
- Full-time
- Remote
- Microsoft Outlook
- Customer service
- Computer literacy
Quick Apply
11d
Reimbursement and Managed Care Analyst
National Jewish Health —Glendale, CO
- $67,454.40 - $89,208.44 a year
- Full-time
- Microsoft Word
- Microsoft Excel
- Hospital
- Wellness program
- Health savings account

I want to receive the latest job alert for Managed Care Analyst

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Managed Care Analyst

MedOp Solutions -
Hickory, NC

Quick Apply

Job Details

Temp-to-hire
8 days ago

Qualifications

VLOOKUP function
Appeals
ICD-10
Medical insurance appeals management
Data analysis software

Full Job Description

Managed Care Analyst

Position Summary:
esponsible for supporting managed care operations through contract analysis, reimbursement validation, payer relations, healthcare analytics, contract administration, and operational support. Performs reimbursement analysis, payment variance investigations, contract modeling support, payer policy research, denial analysis, reporting, and assists with payer negotiations and implementation activities. Collaborates with Revenue Cycle, Finance, Decision Support, Provider Enrollment, HIM, Clinical Operations, and physician leadership to improve reimbursement accuracy, contract compliance, operational efficiency, and value-based reimbursement performance.

Education

Required: Associate degree in Business, Finance, Healthcare Administration, Accounting, Health Information Management, or related field; or equivalent combination of education and experience.
Preferred: Bachelor's degree.
Advanced Microsoft Excel skills required, including Pivot Tables, VLOOKUP/XLOOKUP, What-If analysis, conditional formatting and data analysis functions. Experience with Microsoft 365 applications required.
Preferred: Power BI, SQL, Access Database, contract management and modeling software, and healthcare reporting tools.

Experience

2–5 years of experience in managed care, reimbursement analytics, revenue cycle, healthcare finance, decision support, or payer operations.
Knowledge of Medicare, Medicare Advantage, Medicaid, and Commercial reimbursement methodologies, including CMS fee schedules, APC, DRG, physician fee schedule, and prospective payment systems. (working knowledge of ICD-10-CM/PCS, CPT, HCPCS, MS-DRGs, and APCs).
Working knowledge of hospital and professional billing, claim processing, reimbursement methodologies, and payer payment systems.
Experience reviewing contract language, analyzing reimbursement variances, identifying underpayments and overpayments, monitoring payer trends, researching denials, and supporting appeal preparation.
Preferred: Familiarity with payer grievance processes, CMS complaint processes, Department of Insurance (DOI) complaints, and regulatory payer issue resolution.

Job Specific Performance Expectations

Perform reimbursement validation, payment variance analysis, contract compliance reviews, and payment integrity investigations.
Research reimbursement discrepancies, underpayments, overpayments, denials, and payer policy issues; assist with appeal preparation, submission, and tracking.
Maintain payer contract database, reimbursement methodologies, fee schedules, contract amendments, and renewal tracking.
Assist with financial modeling, reimbursement analysis, contract comparison, and financial impact assessments for new agreements, renewals, and amendments.
Develop, maintain, and distribute payer performance dashboards, reimbursement reports, and operational analytics.
Monitor payer bulletins, policy updates, reimbursement changes, and regulatory communications; communicate operational impacts to affected departments.
Collaborate with Revenue Cycle, HIM, Decision Support, Utilization Review, Case Management, Provider Enrollment, Compliance, Finance, and Clinical Operations.
Coordinate payer meetings, prepare meeting materials, document action items, and follow up on operational issues.
Assist with provider communication regarding payer requirements, reimbursement changes, operational updates, and contract implementation activities.
Maintain contract management software, payer files, departmental documentation, reimbursement references, and operational tracking logs.
Participate in process improvement, revenue optimization, workflow redesign, and automation initiatives.
Crosstrain to provide backup support for Provider Enrollment, contract administration, and other departmental functions as needed.
Complete special projects assigned by the Director of Managed Care.

Core Competencies

Analytical Thinking
Financial Analysis
Problem Solving
Communication
Collaboration
Attention to Detail
Organization & Time Management
Accountability
Adaptability
Confidentiality
Continuous Improvement

Work Environment:
This is a fully on-site position based in Hickory, NC.

#BCIND

Quick Apply

Refine Your Search

Managed Care Analyst jobs

Managed Care Analyst

Managed Care Appeals Analyst

Associate Managed Care Analyst

Managed Care Analyst

Epic Tapestry Analyst (Managed Care Operations) - Remote

Medicare Billing Analyst

Managed Care Analyst I

Managed Care Analyst

Managed Care Analyst

Managed Care Analyst - Capitation Revenue

Contract Analyst (Managed care)

Value Based Care Analyst

Payment Policy Analyst (Remote)

Billing Specialist

Staff AI Product Analyst, Product Management | USA, EST | Remote

Managed Services Analyst I

Quality Assurance Analyst

Contract Analyst

Underpayment Analyst, Denials - Zero Balance (REMOTE)

Reimbursement and Managed Care Analyst

I want to receive the latest job alert for Managed Care Analyst

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected