Managed Care Analyst
Core
Captures, transforms, and interprets complex healthcare data to drive strategic decision-making in payer contracting, payment modeling, and revenue cycle management.
Role type
Managed Care Analyst (Healthcare Analytics)
Builds
Actionable intelligence for contract negotiations, payer performance monitoring, and financial outcomes.
Domain
Healthcare / Managed Care Contracting / Revenue Cycle
Deliverable
dashboards & analysis
Required skills
Payment modeling, contract analytics, revenue cycle KPI analysis, EMR data extraction, reimbursement methodology knowledge, stakeholder communication, market research, system requirements documentation
Preferred skills
Contract negotiation, academic medical center experience, healthcare quality certification, health data analytics certification, compliance auditing, project management
Technologies
Epic, Athena, Experian MPV, FinThrive
Responsibilities
Model commercial and government payment methodologies; analyze contract proposals using fee schedules and DRG; extract and interpret data from EMRs and financial systems; develop dashboards for stakeholders; monitor claims, denials, and payments KPIs; present findings to executive leadership; monitor changes in reimbursement models and payer policies.
Seniority
Mid-level, hands-on IC