Managed Care Analyst 2

We are so glad you are interested in joining Sutter Health!

Organization:

SHSO-Sutter Health System Office-Valley

Position Overview:

This position includes responsibility for negotiating patient-specific Letters of Agreements for reimbursement rates with non-contracted payers to provide access to patients under the direction of Managed Care Department leaders. In addition, this position will support Manager Care leaders with managing negotiation documents, making edits, providing overlay comparisons of proposal documents and resolving issues with Payers for operational units within Sutter. Serves as intermediary between Payers and Sutter related to disputed payments and other projects. This position will also support the Managed Care Department related other projects, such as department training materials, Payer claims research and contract compliance.

Job Description:

EDUCATION:
Equivalent experience will be accepted in lieu of the required degree or diploma.

• Bachelor's: Accounting, Finance, Economics, Statistics, Business or Healthcare Administration or related field

TYPICAL EXPERIENCE:

• 2 years recent relevant experience

SKILLS AND KNOWLEDGE:

• Knowledge of managed care payment/reimbursement methodologies (e.g., Medicaid/Medi-Cal, Medicare, fee-for-service, capitation/sub-capitation) for various types of healthcare entities (e.g., hospital, skilled nursing facilities, physician, ancillary and professional service providers).
• Familiar with healthcare contracting terminologies.
• Familiar with healthcare/hospital operations and structure.
• Knowledgeable of CMS, DHCS, DMHC requirements for providers.
• Organizational skills and attention to details
• Ability to read, comprehend, interpret and apply policies, procedures, practices, contract language, and regulatory and legal requirements, including financial reports.
• Displays a customer service focus in all decisions and actions.
• Ability to prioritize workload to complete assignments accurately and timely, and to meet strict timelines.
• Ability to communicate through verbal and written means, and to present information to a variety of audiences.
• Ability to interact and maintain effective working relationships with those contacted in the performance of required duties.
• Demonstrates respect for cultural and linguistic differences and promotes an inclusive work environment.

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Monday - Friday

Weekend Requirements:

As Needed

Benefits:

Yes

Unions:

No

Position Status:

Non-Exempt

Weekly Hours:

40

Employee Status:

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $38.55 to $57.83 / hour

The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.