Payer Contract Analyst

Summary:

Under the oversight of the Associate Director of Payer Analytics, you will be responsible for a variety of duties relating to analyzing pertinent data from contractual agreements to determine risks in conjunction with applicable standards and guidelines. Develop methods of reviewing, updating, organizing, and analyzing data to provide clear analysis of contract negotiations. This also includes providing analytical support, regular reporting, analysis of revenue related data, accuracy of data, and auditing.

PRIMARY TASKS AND RESPONSIBILITIES:

• Understand, interpret, and apply contractual terms and policies to analysis
• Review contract proposals and seek to improve terms
• Prepare underwriting reports and reviews as requested by management
• Perform underwriting functions in accordance with established standards, guidelines, rates, and coverage
• Review and assess health benefit plan characteristics and evaluate risks
• Plan, organize, and coordinate work assignments
• Provides support via analytical skills and audits related to the Managed Care, Revenue Cycle, Charge Master Maintenance, and Revenue Integrity quality assurance
• Performs other duties and project as assigned

EDUCATION/CERTIFICATIONS & LICENSES:

Bachelor’s degree in mathematics, statistics, finance, or related field

EXPERIENCE:

Minimum of five (5) years of experience in healthcare or related field

CORE COMPETENCIES, KNOWLEDGE/SKILLS/ABILITIES:

Essential competencies and KSAs targeted to successfully performing in role:

• Analysis and Critical Thinking with strong mathematical skills
• Strong interpersonal skills to include effective verbal and written communication
• Solid time management with the ability to prioritize multiple tasks
• Ability to collaborate across various levels of management, departments, and teams
• Comfortable negotiating problems and exploring solutions

VALUES:

Patient First – Keeping the patient at the center of everything we do

Accountability – Taking responsibility for our actions

Commitment & Care – Upholding FCS vision through every action

Team – Working together, one team, one mission

Expectations for all Employees

Every FCS employee is expected to regularly conduct themselves in a professional and respectful manner, to comply with all labor laws, workplace policy and workplace practices. Employees are expected to bring issues of any forms of workplace harassment, discrimination, or other potential improprieties to the attention of their management or the human resources department.

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SCREENINGS – Background, drug, and nicotine screens

Safeguarding our patients and each other is an important part of how we deliver the best care possible to the communities we serve. All offers of employment at Florida Cancer Specialists & Research Institute are contingent upon clear results of a thorough background screening. Additionally, as a condition of employment, FCS requires all new hires to receive various vaccinations, including the influenza vaccine, barring an approved exemption. In addition, FCS is a drug-free workplace, and all new hires will be subject to drug/ nicotine testing. Medical Marijuana cards are not recognized.

EEOC

Florida Cancer Specialists & Research Institute (FCS) is committed to helping individuals with disabilities to participate in the workforce and ensure equal opportunity to compete for jobs. If you require an accommodation to submit a resume for positions at FCS, please email FCS Recruitment (Recruiter@FLCancer.com) for further assistance. Please note this email address is intended to request an accommodation as part of the application process. Any other correspondence will not receive a response.

FCS is an EEO/Affirmative Action Employer and does not discriminate on the basis of age, race, color, religion, gender, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or disability.