MLK Community Healthcare · 2 hours ago
Revenue & Managed Care Analyst
LA Metro Area
Full-time
Onsite
Mid Level
3+ years expMLK Community Healthcare is focused on supporting the financial performance of the hospital. The Revenue and Managed Care Analyst plays a key role in analyzing managed care contracts and optimizing revenue cycle operations to ensure accurate reimbursement from managed care payers, particularly for underserved populations.
Health CareHospitalNon ProfitTherapeutics
Responsibilities
Analyze managed care contracts to assess payment methodologies, reimbursement structures, and contract compliance
Assist in financial impact analysis to support payer negotiations and renewals
Review proposed contract terms for financial feasibility and alignment with hospital revenue goals
Investigate and resolve payer-related issues that impact accounts receivable, including payment variances and delays
Monitor and identify trends in payer behavior that may affect the hospital’s financial sustainability, especially with Medicaid and local health plans
Collaborate with billing, coding, and denial management teams to research root causes and recommend solutions
Act as a liaison between revenue cycle operations, managed care contracting, finance, and patient financial services and collaborate to resolve complex payer issues
Participate in cross-functional meetings to improve payer relationships and revenue performance (Joint Operations Comittiee- JOC)
Partner with finance and billing vendors to ensure contract terms are accurately reflected in vendor’s billing systems
Communicate findings, insights, and recommendations clearly to both technical and non-technical stakeholders
Other duties as assigned
Qualification
Required
Bachelor's degree in Healthcare Administration, Finance, Business, or related field required
Minimum 3–5 years of experience in healthcare revenue cycle, payer analysis, or managed care analytics in a hospital setting
Experience with claims analysis, and payer reimbursement methodologies
Proficient in hospital billing systems (e.g., Cerner) and data tools (Excel, Word, etc)
Knowledge and understanding of DRG, APC, CPT, ICD-10, and revenue codes
Knowledge of Medicare/Medicaid and commercial payer billing regulations
Analytical mindset with attention to detail and problem-solving ability
Preferred
Master's degree
Company
MLK Community Healthcare
MLK Community Healthcare (MLKCH) is an award-winning health system that provides quality care to the medically-underserved community of South Los Angeles.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Elaine Batchlor
CEO
Recent News
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