Contract Analyst (Managed care)

Contract Analyst (Managed Care)

Finance/Accounting/Billing

New York, NY Full-Time/Regular

NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across 6 inpatient locations, its Perlmutter Cancer Center, and over 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise with over $1 billion in active awards from the National Institutes of Health.

Position Summary:

We have an exciting opportunity to join our team as a Contract Analyst. In this role, the successful candidate as the Contract Analyst is responsible for organizing and reviewing financial and utilization data and hospital billing data. This position is responsible for creating and analyzing profit and loss reports and other managed care reports from the cost accounting system. The incumbent will create managed care reports with detailed financial utilization data from other data sources. Additional responsibilities include reviewing all managed care contracts and addressing changes that impact these contracts, validation of contract compliance and other provisions of managed care.

Job Responsibilities:

1. Demonstrates knowledge of the organizations Core Values and incorporates them into the performance of duties.

2. Organizes and reviews financial and utilization data, including insurer claims, eligibility, hospital billing data, payors physician fee schedules and Medicare RBRVS fee schedule.

3. Reviews all managed care contracts; provides analytical support regarding changes impacting contracts, validation of contract compliance and other provisions of managed care.

4. Uses EPSI reporting capability of the hospital decision support system to create managed care reports and to generate and analyze profit and loss reports on individual contracts.

5. Uses Business objects to run detailed charge level data to accurately model contracts during rate negotiations or identify underpayments issues.

6. Assists with loading, auditing and maintaining of payor and physician contracts in EPSI contract modeler in addition to auditing payor contracts loaded in EPIC patient billing system.

7. Prepares managed care reports with detailed financial utilization information on a fee-for-service basis by payer, provider type and by specialty.

8. Provides assistance to Hospital Finance Department to support financial management and evaluation of fee for service hospital contract and identify methods for improving report efficiency. As well as the FGP and other Hospital department ad hoc reporting.

9. Monitors and tracks ongoing claims resolution activities and other practice or hospital service issues that impact reimbursement. Provides log-in access to payor websites by request.

10. Assist Managed Care analytics with Contract modeling on a payor by payor basis.

11. Perform tasks related to pricing transparency and other government regulatory requirements

12. Reviews and identifies yearly CPT coding changes and impact on current contracts

Minimum Qualifications:

To qualify you must have a Bachelors degree in Business Administration or relevant discipline and 1-2 years relevant experience or an equivalent combination of education and experience. Proficiency using relational databases, database concepts and software applications; must have MS Access and Excel knowledge. Excellent interpersonal and presentation skills. Knowledge of healthcare terms and reimbursement methodologies. Strong analytical and problem solving skills

Preferred Qualifications:

Familiarity with Crystal/EPSi reporting and EPIC.

Qualified candidates must be able to effectively communicate with all levels of the organization. NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family. NYU Langone Health is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online.

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NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $70,481.60 - $85,000 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

To view the Pay Transparency Notice, please click here