Job Description:
Role is expected to be a SME (subject matter expert) in one or more of the following as directed: Performs a variety of detailed analysis to model commercial and government payments, performs underpayment recovery audits, escalates contractual and underpayment issues to appropriate internal or external contact, perform and support contract negotiations for Hospital, Physician, behavioral health, Ancillary services like vision, hearing, home health, hospice, ambulance and other ancillary service lines with payers for commercial, Medicare replacement plans, Medicaid replacement plans, other third-party payers and Value Based agreements. This position will also provide a high level of support for other departmental activities supporting contracting, contract management analytics, contract storage, contract retrieval, contract interpretation and communication. Participate and lead contract negotiations, manage reconciliation of third party payments to optimize contractual reimbursement and provide strategic analysis for decision making. Analysts in level II roles provide support to leaders at all levels of the organization. In a level II role, analysts are expected to provide input and guidance to other members of the, Population Health team, Contracting and Payer Strategy team, and Finance team proactively identifies opportunities and work on projects with moderate to high complexity, risk and scope. In this role, analysts will be asked to lead projects, identify opportunities and develop recommendations for improvements. Work Experience: Minimum three years' experience with creating or interpreting complex financial models, detailed knowledge of insurance and third-party reimbursement processes. Preferred contract management software experience.
Education Qualifications:
Bachelor's degree in health care, accounting, business, or related field or equivalent experience
Licensure/Certification Qualifications:
No certification/licensure required.
FTE
1
Shift Rotation
Day Rotation (United States of America)
Shift Start Time
08:00
Shift End Time
4:30
Effective December 1, 2019: Job offers are contingent upon successful completion of a post-offer assessment, including a urine drug screen, immunization review, proof of required vaccinations, and background check. Essentia Health is committed to maintaining a work environment free from the influence of illegal drugs and alcohol.
Essentia Health EEO:
Essentia Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, sexual identity, national origin, disability, protected veteran status, or any other characteristic protected by law.
Equal Employment Opportunity (EEO) at Essentia
It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.
