Children's Nebraska · 4 hours ago
Sr Managed Care Contract and Revenue Cycle Analyst
Omaha, NE
Full-time, Contract
Onsite
Senior Level
5+ years expChildren's Nebraska is the region’s only full-service pediatric healthcare center, dedicated to providing excellent care for children. The Sr. Managed Care Contract and Revenue Cycle Analyst will perform complex analysis and modeling of managed care contracts, support revenue cycle operations, and work closely with leadership to identify improvement opportunities.
Health CareMedicalNon Profit
Responsibilities
Provides analytical support to the Director of Managed Care
Review and project contract performance based on modeling of actual and representative samples
Gather and interpret data from a variety of sources to provide accurate and complex data analysis supporting annual payor contract negotiations
Provides analytical support and reconciliation of contract provisions and disputes
Perform detailed analysis of the financial and operational impact of clinical pathway change within the organization
Track and monitor payer related issues and communicate to the Director of Managed Care
Completes month-end balancing, scheduled month-end reports, scorecards, ad hoc reporting and data analysis as needed to support revenue cycle operations and financial reporting
Provides detailed measurement & interpretation; prepares analysis of data and presents findings to RCM leadership team and Finance with analyses of revenue cycle operations and financial performance as required
Provides reports and analysis to identify significant variances to expected performance outcomes & metrics
Prepares presentations that communicate complex analysis and findings in a concise and interpretable manner to support strategic initiatives
Performs intermediate to advanced spreadsheet analyses & database solutions using Epic reporting tools and other software such as Excel & MS Access
Assist with the analysis of accounts receivable financial performance based on analysis of claims processing, payer remittances, payment variances and denials
Uses the information to analyze and make recommendations for improvements to the RCM leadership team
Provides support to the CBO HB & PB Denials Management Committees through development and analysis of denial reports and root cause analysis
Coordinates research, analysis, and remediation of moderately complex data with I.T. which directly impacts the Revenue Cycle and provides recommendations in support of critical business decisions when necessary
Performs annual fee schedule analysis to identify opportunities to maximize reimbursement
Promote a culture of collaborative, customer-focused service delivery with both internal and external resources
Perform physical requirements as described in the Physical Requirements section
Regular attendance at work is an essential function of the job
Qualification
Required
Bachelor's Degree from an accredited college or university in healthcare administration, information systems, finance or related field required, or equivalent work experience
Minimum 5 years' experience in hospital and physician revenue cycle, billing and collections processes, or healthcare finance
Minimum 2 years' experience in analysis of financial, reimbursement, or managed care contract modeling
Knowledge of revenue cycle functions, reimbursement, billing terminology, and best practices
Knowledge of internal operations to facilitate appropriate revenue cycle management tactics
Knowledge of the current healthcare climate, including HIPAA standards and governmental programs and regulations
Knowledge of CPT, HCPCS and revenue codes and their effect on reimbursement
Ability to solve complex problems and adapt to process variances in situations where limited standardization exists
Ability to communicate effectively both verbally and in writing
Ability to complete and analyze data queries, scorecards, detailed statistical measurement and interpretation, and financial forecasts
Intermediate to Advanced knowledge of Excel and Word - required
Preferred
EPIC - EPIC Certification in revenue cycle reporting modules
Company
Children's Nebraska
At Children’s Nebraska, our mission is to improve the life of every child through exceptional care, advocacy, research and education.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
G
Gary Perkins
President & CEO
Recent News
Silicon Prairie News
2025-05-17
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