Senior analyst Jobs in Ventura, CA

Job Posting

Mount Sinai is one of the largest U.S. health systems with a strong reputation for quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients. We are accelerating a transition to a business model focused on population health management our goal is to keep entire communities healthy and out of the hospital. Mount Sinai Health Partners (MSHP) is the team driving this transformation within Mount Sinai. The team includes 400+ employees with clinical, contracting, finance, IT, analytics, operations, and product development expertise.

The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on : Facility related Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of implementing Facility and Ancillary Contracts across the Mount Sinai Health System.

MSHP seeks a Senior Contract Compliance (Professional Billing) Analyst who will primarily be responsible for tracking, trending, and analyzing professional billing (PB) contract compliance issues. This role requires a strong focus on identifying violations in PB contract terms, escalating significant issues to Directors for potential legal intervention, and assisting in the escalation of claims that may require involvement from insurance carriers or legal entities. The ideal candidate should have a comprehensive understanding of the revenue cycle, contract management, and a keen eye for detail in identifying potential compliance risks.