Job Description

Location: Steward Health Care
Posted Date: 6/22/2021

PRIMARY RESPONSIBILITIES:

  • Ability to read, interpret and apply modeling logic within Contract Modeling software accurately.
  • Responsible for loading managed care contracts to calculate expected reimbursement
  • Includes new contracts, rate changes and fee schedule maintenance
  • Provides analytic support for contract variance and monitoring of system and payer performance
  • Manages modeling ques, internal help desk tickets timely and accurately
  • Communicates, reviews and provides feedback and guidance to managed care to assist in the contract negotiation process.
  • This includes making recommendations on specific contract language that may have any financial impact.
  • Provides training and communicate contract modeling updates. Works closely with reimbursement and facility CFOS on model updates and impacts to net revenue, if material or applicable
  • Maintains current knowledge of payer reimbursement policies

SKILL OR EXPERIENCE REQUIREMENTS:

  • Minimum 8 years prior hospital revenue cycle experience required
  • Minimum 8 years’ experience with Hospital Contract and/or Financial Modeling
  • Managed Care Knowledge and understanding of various hospital payment methodologies both commercial and government.
  • Microsoft Office proficiency required.
  • Ability to communicate clearly and effectively
  • Solid competencies in assessment and critical thinking

EDUCATION OR SPECIFIC TRAINING REQUIREMENTS:
Undergraduate degree or equivalent combination of education and work experience.

ADDITIONAL SKILLS NEEDED:
Must have analytical skills and the ability to evaluate data effectively.

Application Instructions

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