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Mediant Health Resources · 11 hours ago

Managed Care Contracting Reimbursement Analyst

Detroit, MI

Full-time

Onsite

Mid Level

Mediant Health Resources is a company focused on healthcare financial solutions, and they are seeking a Managed Care Contracting Reimbursement Analyst. The role involves leading financial analysis, developing reporting tools, managing rate review processes, and ensuring compliance with reimbursement methodologies.

Health CareHospitalInformation Technology

Growth Opportunities

Responsibilities

Independently lead financial and reimbursement analysis, evaluating rate proposals, payer contract terms, and health plan methodologies to identify optimization opportunities

Develop and maintain advanced financial reporting using EPSi, SQL, Epic Clarity, and Power BI to assess contracted rates, reimbursement trends, and performance metrics

Manage end-to-end rate review processes and collaborate with contract modeling teams to ensure accurate implementation of negotiated terms within pricing and contract management systems

Monitor data integrity across financial systems, proactively improving processes, and providing insights and recommendations to Contracting leadership based on payer reporting trends

Maintain expertise in reimbursement methodologies, payer policies, and regulatory requirements while supporting system-wide financial projects, special initiatives, and committee activities

Qualification

Financial analysisReimbursement methodologiesSQLPower BIEPSiData integrityProcess improvementCollaboration

Required

Independently lead financial and reimbursement analysis, evaluating rate proposals, payer contract terms, and health plan methodologies to identify optimization opportunities

Develop and maintain advanced financial reporting using EPSi, SQL, Epic Clarity, and Power BI to assess contracted rates, reimbursement trends, and performance metrics

Manage end-to-end rate review processes and collaborate with contract modeling teams to ensure accurate implementation of negotiated terms within pricing and contract management systems

Monitor data integrity across financial systems, proactively improving processes, and providing insights and recommendations to Contracting leadership based on payer reporting trends

Maintain expertise in reimbursement methodologies, payer policies, and regulatory requirements while supporting system-wide financial projects, special initiatives, and committee activities