Medical and Health Services Managers jobs in Missouri

Managed Care Analyst

SUMMARY: Under the direction of the Reimbursement and Managed Care Analytics Director, the Managed Care Analyst is responsible for helping ensure the financial health of NKC Health and NKC Health Medical Group through support of enterprise managed care activities. Additional responsibilities include, but are not limited to the following:

Responsible for loading, modeling, support and maintenance of the managed care contracts and fee schedules within the contract management system, including both Hospital and Professional agreements.
Participates in contract modeling and other financial analysis using significant amounts of data that must be interpreted to inform decision-making by the managed care contracting and operations teams.
Requires a deep understanding of healthcare reimbursement for hospitals and medical groups, contract negotiation concepts, financial analysis, and functionality of contract management databases.
Works closely with Managed Care, Patient Financial Services, Revenue Integrity, Business Intelligence, and Meritas Business Office.

EXPERIENCE:

Minimum 2 years of experience in a Health System or Managed Care Organization (MCO), with demonstrated experience in healthcare analytics.
Demonstrated experience in problem-solving and project management.
Experience with contract management and modeling software, managed care principals, hospital and professional coding, reimbursement, and financial terms such as DRG, CPT, HCPCS, ICD-10, APC, ASC groupers, chargemaster, revenue codes and payor policies preferred.
Experience with Cerner Patient Accounting preferred.

SPECIAL SKILLS:

Highly skilled in data collection, data analysis (Power BI), advanced Excel knowledge (including pivot functionality and advanced formulas), and relational databases.
Experience with database extraction of patient accounting, medical records, and patient healthcare record data.
Knowledge of hospital and physician reimbursement methodologies (i.e. DRG, per diem, fee schedule, APC).
Working knowledge of billing/coding terminology (i.e. ICD-10, CPT, Revenue codes).

OTHER:

Excellent organization and attention to detail are required.
Ability to communicate complex information to various audiences.
Able to work in a fast-paced environment
Problem solve issues where analysis is required; decisions and actions have a direct impact on hospital financials.
Works independently, and as part of a team.
Multitask and prioritize multiple tasks to meet deadlines.
Takes ownership of job, and proactively responds to commitments.
Takes specific actions to improve own work methods or systems.
Develops and implements new and unique ideas.

LICENSE/CERT: Preferred: CCS (Certified Coding Specialist)

EDUCATION: Required: Bachelors - Business, Bachelors - Finance, Bachelors - Accounting, Bachelors - Health Care Management

Managed Care Analyst

HCBS SME/Lead Business Analyst

Clinical Director (Board Certified Behavior Analyst)

Board Certified Behavior Analyst (BCBA)

DIRECTOR - CLINIC OPERATIONS

LPN Director of Nursing 5k Sign On Bon 8a-5p (Full Time)

Intake Specialist

Intake Specialist

Dermatology Clinic Manager

MOSDOH - Clinical Operations Manager

Administrator - Assisted Living RCAL

Manager of Clinical Nutrition Services

LPN/Nurse Manager $5k Sign On $36-$38 6am-6pm (Full-Time)

Director - Women's Care

Rehab Therapy Manager-PTA- Arcadia Valley- Ironton, MO

LPN/Nurse Manager $3k Sign On $33-$35 7am-7pm (Part-Time)

Director of Nursing

Clinic Supervisor

Managed Care Analyst at North Kansas City Hospital – North Kansas City, Missouri

Explore Related Opportunities

About This Position

Scan to Apply

Job Location

Frequently asked questions about this position