Sr. Contract Modeling Analyst - Managed Care

Shift: Day
Schedule: Full - Time Regular

Ardent Health Services invests in people, technology, facilities and communities, producing high-quality care and extraordinary results. Based in Nashville, Tennessee, Ardent’s subsidiaries own and operate 31 hospitals in seven states with more than 25,000 employees including 1,150 employed providers. Ardent facilities exceed national averages in Overall Hospital Quality Star Rating as ranked by the Centers for Medicare & Medicaid Services; 89 percent of its hospitals received a three-star rating or above in comparison with 73 percent of all hospitals ranked. Seven of the company's hospitals were recognized by Modern Healthcare as "Best Places to Work" in 2017 – more than any other system in the country. Ardent's corporate office was named "Top Work Places" for Nashville based companies in 2017 & 2018.

We have an exciting opportunity for a Sr. Contract Modeling Analyst to join our Revenue Integrity team. Reporting to the AVP, Revenue Integrity, the Senior Contract Analyst will ensure compliance with corporate policies regarding payment and contractual allowance verification with all payers by managing the software system that contains all payer contracts and calculations of expected reimbursement. The successful candidate will provide decision support to management as needed for new and or changing reimbursement rates. This role is also responsible for providing reporting of payment variance.

Primary Duties

  • Load contract language by facility and payor into the contract management system
  • Audit contracts prior to movement into production within contract management system
  • Coordinate changes needed to contract profiles or system set up
  • Maintain working relationships with Managed Care Department to ensure timely loading of contracts and proper interpretation of contract language
  • Coordinate with Reimbursement Managers to identify changes for governmental payors for contract loading
  • Monitor payor websites for changes to payment rates or methods
  • Provide analysis of data in contract management system to facility and corporate management as requested
  • Prepare monthly reports providing analysis of payment variances for distribution to facility CFO’s and Market CBO’s.
  • Through various reviews analyze data for revenue opportunities for assigned market
  • Other duties as assigned

QUALIFICATIONS

Education: Degree, BBA or BS in Accounting, Finance or Business preferred or equivalent work experience

Experience: 

  • 3-5 years’ experience with contract management and or applicable analytical experience
  • 2+ years of experience working with reimbursement methodology required
  • Epic or nThrive (MedAssets) experience is a plus
  • Knowledge of Managed Care Contracts
 Additional Requirements:
  • Excellent verbal, analytical and interpersonal skills.
  • Intermediate level of Excel knowledge required for optimal functionality in the role.
  • Proficiency in Microsoft office suite.
  • Knowledge of Managed Care Contracts and Medicare payment methodologies required.
  • Epic experience preferred