Mass General Brigham
Site: Mass General Brigham Incorporated
Job Summary Under direction of the Manager, the Managed Care Analyst I will be responsible for identifying payment variances, collecting underpayments from third party payers, and notifying management when overpayments are detected. Will also be responsible for identifying payment trends, calculating impact and reporting findings to manager. Will interact with Mass General Brigham Finance staff and payor liaisons to understand root causes and make recommendations for resolution that will maximize future reimbursement.
Qualifications Education
Associate's Degree Related Field of Study required
Bachelor's Degree Related Field of Study preferred
Experience
Experience in accounting or finance 2-3 years required
Experience in a role within a large healthcare organization 2-3 years preferred
Knowledge, Skills and Abilities
Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization
Ability to successfully interact and collaborate with others of different skill sets, backgrounds and levels within and external to the organization
Knowledge of Third Party billing rules and reimbursement methodologies
Strong financial analytical, problem solving and negotiation skills
Ability to effectively conduct meetings, both formal and informal
Proficient with Excel, Access a plus
Experience with contract modeling tool (FinThrive or Experian a plus)
Essential Functions
Use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration
Independently and accurately, analyze third party payment variances and determine root causes for discrepancies, utilizing database tools in a timely manner
Resolve underpayment variances directly with payors when indicated
Provide qualitative reporting to manager on overpayments
Provide continuous feedback to manager
Participate in payor operations and revenue analyses meetings internally and externally as necessary
Compile summary variance reports for Management
Act as liaison between Payer Variance team and our zero balance vendors – responsibilities may include, but are not limited to, contract research, payer escalations, invoice management, etc.
Actively participate in process improvement initiatives including, but not limited to the MGB RCO ‘ESP – Everyone Solves Problems’ initiative
Other duties as assigned
Additional Job Details
Remote Type:
Remote
Work Location:
399 Revolution Drive
Scheduled Weekly Hours:
40
Employee Type:
Regular
Work Shift:
Day (United States of America)
Pay Range:
$52,000.00 - $74,401.60/Annual
Grade:
5
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.
Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
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Job Summary Under direction of the Manager, the Managed Care Analyst I will be responsible for identifying payment variances, collecting underpayments from third party payers, and notifying management when overpayments are detected. Will also be responsible for identifying payment trends, calculating impact and reporting findings to manager. Will interact with Mass General Brigham Finance staff and payor liaisons to understand root causes and make recommendations for resolution that will maximize future reimbursement.
Qualifications Education
Associate's Degree Related Field of Study required
Bachelor's Degree Related Field of Study preferred
Experience
Experience in accounting or finance 2-3 years required
Experience in a role within a large healthcare organization 2-3 years preferred
Knowledge, Skills and Abilities
Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization
Ability to successfully interact and collaborate with others of different skill sets, backgrounds and levels within and external to the organization
Knowledge of Third Party billing rules and reimbursement methodologies
Strong financial analytical, problem solving and negotiation skills
Ability to effectively conduct meetings, both formal and informal
Proficient with Excel, Access a plus
Experience with contract modeling tool (FinThrive or Experian a plus)
Essential Functions
Use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration
Independently and accurately, analyze third party payment variances and determine root causes for discrepancies, utilizing database tools in a timely manner
Resolve underpayment variances directly with payors when indicated
Provide qualitative reporting to manager on overpayments
Provide continuous feedback to manager
Participate in payor operations and revenue analyses meetings internally and externally as necessary
Compile summary variance reports for Management
Act as liaison between Payer Variance team and our zero balance vendors – responsibilities may include, but are not limited to, contract research, payer escalations, invoice management, etc.
Actively participate in process improvement initiatives including, but not limited to the MGB RCO ‘ESP – Everyone Solves Problems’ initiative
Other duties as assigned
Additional Job Details
Remote Type:
Remote
Work Location:
399 Revolution Drive
Scheduled Weekly Hours:
40
Employee Type:
Regular
Work Shift:
Day (United States of America)
Pay Range:
$52,000.00 - $74,401.60/Annual
Grade:
5
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.
Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
#J-18808-Ljbffr