Children's National Medical Center
Senior Managed Care Analyst
Children's National Medical Center, Silver Spring, Maryland, United States, 20900
Job Description – Senior Managed Care Analyst (250002MO)
Senior Managed Care Analyst – (250002MO)
Description The Senior Managed Care Analyst will collect and analyze data on costs, charges and utilization to support negotiations with managed care companies. Will develop and implement appropriate tools to expedite effective evaluation and monitoring of managed care contract performance and service utilization.
Qualifications
Minimum Education Bachelor’s Degree in Business, Accounting, Health Care Administration, Economics or Mathematics. (Required) Master’s Degree (Preferred)
Minimum Work Experience 3 years Relevant work experience in financial and/or utilization analysis. (Required)
Required Skills/Knowledge Proven analytical skills including ability to make recommendations based on financial analyses. Superior PC skills including proficiency in Word, spreadsheet analysis and database management. Experience with financial and utilization analysis. Ability to work in a team environment with other analysts, managers, and physicians. Strong communication and organizational skills. Proficiency in presentation of analytical results. Previous experience in health care is highly desirable, including experience with hospital/physician information and patient accounting information systems.
Contract Provisions Assessment
Develop reports to assess existing contracts by type of service.
Develop models to assess impact of alternative contract rates to support negotiations.
Operational Issues
Provide updated reports for inpatient and outpatient service categories.
Complete ad hoc reports for individual payors as needed.
Provide routine reports to monitor plan utilization and contract performance.
Provide comprehensive reports for evaluation of FY results.
Analyze
Provide analysis of cost information using available cost tables.
Safety
Speak up when team members appear to exhibit unsafe behavior or performance.
Continuously validate and verify information needed for decision making or documentation.
Stop in the face of uncertainty and takes time to resolve the situation.
Demonstrate accurate, clear and timely verbal and written communication.
Actively promote safety for patients, families, visitors and co‑workers.
Attend carefully to important details – practicing Stop, Think, Act and Review in order to self‑check behavior and performance.
Organizational Accountabilities – Quality Assurance
Review rules and identify problem areas to assure expected payments are correct.
Organizational Commitment/Identification
Partner in the mission and upholds the core principles of the organization.
Committed to diversity and recognizes the value of cultural and ethnic differences.
Demonstrate personal and professional integrity.
Maintain confidentiality at all times.
Customer Service
Anticipate and respond to customer needs; follows up until needs are met.
Teamwork / Communication
Demonstrate collaborative and respectful behavior.
Partner with all team members to achieve goals.
Receptive to others’ ideas and opinions.
Performance Improvement / Problem‑solving
Contribute to a positive work environment.
Demonstrate flexibility and willingness to change.
Identify opportunities to improve clinical and administrative processes.
Make appropriate decisions, using sound judgment.
Use resources efficiently.
Search for less costly ways of doing things.
Primary Location Maryland – Silver Spring
Work Locations Tech Hill, 12211 Plum Orchard Drive, Silver Spring, MD 20904
Job Accounting & Finance
Organization Finance
Position Status : R (Regular) – FT – Full‑Time
Shift : Day
Work Schedule : M‑F, 08:30‑16:30
Job Posting Oct 6, 2025, 2:44:57 PM
Full‑Time Salary Range $62,088 – $103,480
Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your Rights Pay Transparency Nondiscrimination Poster.
Please note that it is the policy of Children's National Hospital to ensure a “drug‑free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children's National and its affiliates maintain the right, in accordance with our policy, to enforce a drug‑free workplace, including prohibiting recreational or prescribed marijuana.
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Description The Senior Managed Care Analyst will collect and analyze data on costs, charges and utilization to support negotiations with managed care companies. Will develop and implement appropriate tools to expedite effective evaluation and monitoring of managed care contract performance and service utilization.
Qualifications
Minimum Education Bachelor’s Degree in Business, Accounting, Health Care Administration, Economics or Mathematics. (Required) Master’s Degree (Preferred)
Minimum Work Experience 3 years Relevant work experience in financial and/or utilization analysis. (Required)
Required Skills/Knowledge Proven analytical skills including ability to make recommendations based on financial analyses. Superior PC skills including proficiency in Word, spreadsheet analysis and database management. Experience with financial and utilization analysis. Ability to work in a team environment with other analysts, managers, and physicians. Strong communication and organizational skills. Proficiency in presentation of analytical results. Previous experience in health care is highly desirable, including experience with hospital/physician information and patient accounting information systems.
Contract Provisions Assessment
Develop reports to assess existing contracts by type of service.
Develop models to assess impact of alternative contract rates to support negotiations.
Operational Issues
Provide updated reports for inpatient and outpatient service categories.
Complete ad hoc reports for individual payors as needed.
Provide routine reports to monitor plan utilization and contract performance.
Provide comprehensive reports for evaluation of FY results.
Analyze
Provide analysis of cost information using available cost tables.
Safety
Speak up when team members appear to exhibit unsafe behavior or performance.
Continuously validate and verify information needed for decision making or documentation.
Stop in the face of uncertainty and takes time to resolve the situation.
Demonstrate accurate, clear and timely verbal and written communication.
Actively promote safety for patients, families, visitors and co‑workers.
Attend carefully to important details – practicing Stop, Think, Act and Review in order to self‑check behavior and performance.
Organizational Accountabilities – Quality Assurance
Review rules and identify problem areas to assure expected payments are correct.
Organizational Commitment/Identification
Partner in the mission and upholds the core principles of the organization.
Committed to diversity and recognizes the value of cultural and ethnic differences.
Demonstrate personal and professional integrity.
Maintain confidentiality at all times.
Customer Service
Anticipate and respond to customer needs; follows up until needs are met.
Teamwork / Communication
Demonstrate collaborative and respectful behavior.
Partner with all team members to achieve goals.
Receptive to others’ ideas and opinions.
Performance Improvement / Problem‑solving
Contribute to a positive work environment.
Demonstrate flexibility and willingness to change.
Identify opportunities to improve clinical and administrative processes.
Make appropriate decisions, using sound judgment.
Use resources efficiently.
Search for less costly ways of doing things.
Primary Location Maryland – Silver Spring
Work Locations Tech Hill, 12211 Plum Orchard Drive, Silver Spring, MD 20904
Job Accounting & Finance
Organization Finance
Position Status : R (Regular) – FT – Full‑Time
Shift : Day
Work Schedule : M‑F, 08:30‑16:30
Job Posting Oct 6, 2025, 2:44:57 PM
Full‑Time Salary Range $62,088 – $103,480
Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your Rights Pay Transparency Nondiscrimination Poster.
Please note that it is the policy of Children's National Hospital to ensure a “drug‑free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children's National and its affiliates maintain the right, in accordance with our policy, to enforce a drug‑free workplace, including prohibiting recreational or prescribed marijuana.
#J-18808-Ljbffr