Health Data Operations Specialist (On-site)

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The Health Data Analyst is responsible for assisting the Managed Care Director in developing and implementing strategies to improve managed care net revenue, payor and business relations, and cash collections for University Medical Center and its affiliates.

Reports to Director, Managed Care

Job Specific Responsibilities

Daily assignments may include but are not limited to:

• Assist with new and current contracts to increase inpatient and outpatient net revenue.
• Assist in negotiating, renegotiating managed care agreements, interacting with payors on contract compliance, and payment issues.
• Responsible for standard and ad-hoc extracts/reports across multiple data sources.
• Assist with Provider credentialing and enrollment.
• Analysis of managed care contract performance, reimbursement trends, and payment variances.
• Maintain data, extract, analyze data and trends to provide business insights based on findings.
• Create relevant and user-friendly reports and presentations for internal and external customers.
• Provide suggestions on ways to improve payer contracts, quality, and cost effectiveness for the Hospital System.
• All other assigned duties as requested by assigned department.

Education and Experience

• High School Diploma or GED
• Bachelor's degree in Healthcare Administration, Finance, Accounting, Economics, Data Analytics, or a related field preferred.
• Two (2) years of experience in healthcare data analytics, managed care, payor operations, healthcare finance/revenue cycle, healthcare operations, or a related field.
• Experience working with healthcare payers and reimbursement data preferred.

Required Licensures/Certifications/Registrations

• Certification by the Healthcare Financial Management Association (HFMA) preferred or expected within 24 months of employment.

Knowledge, Skills and Abilities

• Proficient in use of Microsoft Office Suite applications, including Access and Excel.
• Demonstrated ability to present to small and large audience and explain analytical findings.
• Demonstrated ability with data analytics with ability to generate graphs/reports from analytical results.
• Analytical mindset with good problem-solving skills in using data.
• Good interpersonal skills.

Interaction with Other Departments and Other Relationships

Interacts internally with Patient Financial Services (Patient Accounting), marketing, Financial Counseling, Information Systems (IT), Compliance, Case Management, Medical Director(s) and UMC Physicians (UMCP). Also interacts externally with Texas Tech Health Sciences Center, TeamChoice, various payors, health plan, and other providers.

Physical Capabilities

Occasionally exerts up to 25 lbs. of force and/or frequently exerts a small amount of force to lift, carry, push, pull, and move objects. Work involves sitting most of the time but may involve walking or standing for brief periods of time. This position requires frequent typing/keyboarding and some reaching in all directions. Must be available to work 8:00 am to 5:00 pm Monday through Friday plus after hours as needed. Be available by pager or cellphone as needed.

Environmental/Working Conditions

This position is subject to inside environmental conditions; protection from weather, but not necessarily temperature changes.

UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

• Request for accommodations in the hire process should be directed to UMC Human Resources.*