Ocean State Job Lot
Revenue & Managed Care Analyst
Ocean State Job Lot, Los Angeles, California, United States, 90079
We understand the requirements of central HR and our solutions serve the critical needs of both central HR and the individual manager in the field. We enable uniform hiring policies across your entire organization, and account for a fluctuating need for talent with an evergreen hiring model for the field. This approach respects local requirements, seasonal needs in staffing, and the operational demands of local candidate screening and scheduling.
If interested, please apply and submit your resume to Marismartinez@mlkch.org
POSITION SUMMARY
The Revenue and Managed Care Analyst plays a key role in supporting the financial performance of the hospital by analyzing managed care contracts, payer reimbursement trends, and revenue cycle performance metrics. The Analyst supports the mission of the community safety net hospital by ensuring accurate reimbursement from managed care payers, particularly Medicaid and other government programs. This role is critical in analyzing payer performance, optimizing managed care contracts, and improving revenue cycle operations to sustain care for underserved and vulnerable populations. ESSENTIAL DUTIES AND RESPONSIBILITIES
Analyze managed care contracts to assess payment methodologies, reimbursement structures, and contract compliance. Assist in financial impact analysis to support payer negotiations and renewals. Review proposed contract terms for financial feasibility and alignment with hospital revenue goals. Investigate and resolve payer-related issues that impact accounts receivable, including payment variances and delays. Monitor and identify trends in payer behavior that may affect the hospital’s financial sustainability, especially with Medicaid and local health plans. Collaborate with billing, coding, and denial management teams to research root causes and recommend solutions. Act as a liaison between revenue cycle operations, managed care contracting, finance, and patient financial services and collaborate to resolve complex payer issues. Participate in cross-functional meetings to improve payer relationships and revenue performance (Joint Operations Comittiee- JOC) Partner with finance and billing vendors to ensure contract terms are accurately reflected in vendor’s billing systems. Communicate findings, insights, and recommendations clearly to both technical and non-technical stakeholders. Other duties as assigned POSITION REQUIREMENTS
A. Education Bachelor’s degree in Healthcare Administration, Finance, Business, or related field required; Master’s degree preferred. B. Qualifications/Experience Minimum 3–5 years of experience in healthcare revenue cycle, payer analysis, or managed care analytics in a hospital setting. Experience with claims analysis, and payer reimbursement methodologies. C. Special Skills/Knowledge Proficient in hospital billing systems (e.g., Cerner) and data tools (Excel, Word, etc) Knowledge and understanding of DRG, APC, CPT, ICD-10, and revenue codes. Knowledge of Medicare/Medicaid and commercial payer billing regulations. Analytical mindset with attention to detail and problem-solving ability. Equal Rights Employer Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, national origin, age, disability, genetic information, citizenship status, military service, or any other status protected by federal, state, or local laws. This application is intended for use in evaluating your application for employment. Please click the link below to view the E-verify or Right to Work information. E-Verify/ Right to Work MLK Community Healthcare 1680 E 120th Street Los Angeles, CA 90059 Tel: 424-338-8000 Email: info@mlkch.org www.mlkch.org
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The Revenue and Managed Care Analyst plays a key role in supporting the financial performance of the hospital by analyzing managed care contracts, payer reimbursement trends, and revenue cycle performance metrics. The Analyst supports the mission of the community safety net hospital by ensuring accurate reimbursement from managed care payers, particularly Medicaid and other government programs. This role is critical in analyzing payer performance, optimizing managed care contracts, and improving revenue cycle operations to sustain care for underserved and vulnerable populations. ESSENTIAL DUTIES AND RESPONSIBILITIES
Analyze managed care contracts to assess payment methodologies, reimbursement structures, and contract compliance. Assist in financial impact analysis to support payer negotiations and renewals. Review proposed contract terms for financial feasibility and alignment with hospital revenue goals. Investigate and resolve payer-related issues that impact accounts receivable, including payment variances and delays. Monitor and identify trends in payer behavior that may affect the hospital’s financial sustainability, especially with Medicaid and local health plans. Collaborate with billing, coding, and denial management teams to research root causes and recommend solutions. Act as a liaison between revenue cycle operations, managed care contracting, finance, and patient financial services and collaborate to resolve complex payer issues. Participate in cross-functional meetings to improve payer relationships and revenue performance (Joint Operations Comittiee- JOC) Partner with finance and billing vendors to ensure contract terms are accurately reflected in vendor’s billing systems. Communicate findings, insights, and recommendations clearly to both technical and non-technical stakeholders. Other duties as assigned POSITION REQUIREMENTS
A. Education Bachelor’s degree in Healthcare Administration, Finance, Business, or related field required; Master’s degree preferred. B. Qualifications/Experience Minimum 3–5 years of experience in healthcare revenue cycle, payer analysis, or managed care analytics in a hospital setting. Experience with claims analysis, and payer reimbursement methodologies. C. Special Skills/Knowledge Proficient in hospital billing systems (e.g., Cerner) and data tools (Excel, Word, etc) Knowledge and understanding of DRG, APC, CPT, ICD-10, and revenue codes. Knowledge of Medicare/Medicaid and commercial payer billing regulations. Analytical mindset with attention to detail and problem-solving ability. Equal Rights Employer Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, national origin, age, disability, genetic information, citizenship status, military service, or any other status protected by federal, state, or local laws. This application is intended for use in evaluating your application for employment. Please click the link below to view the E-verify or Right to Work information. E-Verify/ Right to Work MLK Community Healthcare 1680 E 120th Street Los Angeles, CA 90059 Tel: 424-338-8000 Email: info@mlkch.org www.mlkch.org
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