Tal Healthcare
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USD
70000
100000
YEAR
true
Managed Care Analyst
101 East Post Road, 2nd floor , Human Resources
White Plains,
NY
10601
US
2025-04-09
2025-05-23
Department: Finance
Job Number: 6623
Pay Rate: $70000-100000
Employment Type: Full Time
Job Description
Our client, a leading non-profit medical center in Westchester County, is seeking a detail-oriented and analytical Managed Care Analyst to support its growing revenue cycle operations. This role is essential to ensuring accurate reimbursement from third-party payers and maintaining contract compliance. You’ll play a key role in data analysis, contract modeling, audit support, and payer relations—ultimately strengthening the organization’s financial health and operational effectiveness. This is a high-impact role at a mission-driven medical center recognized for its commitment to community health and patient-centered care. You'll be working with an engaged team that values accountability, innovation, and continuous improvement in a collaborative and supportive environment.
Responsibilities
- Contract Analysis & Payment Reconciliation
- Analyze reimbursement data based on contract structure and hospital-negotiated rates.
- Audit and reconcile plan payments to identify and report contract variances.
- Collaborate with payers to resolve discrepancies related to underpayments or non-compliance.
- Maintain escalation files and track outcomes of payer escalations.
- Contract Support & Maintenance
- Assist in testing, validating, and maintaining contract terms and fee schedules in both host systems and contract modeling software.
- Participate in the preparation of contract reference guides and summary documents for distribution across the revenue cycle team.
- Reporting & Data Analytics
- Collect, model, and analyze claims data to support contract negotiations and performance assessments.
- Prepare monthly reports and dashboards to monitor plan performance and financial impact.
- Identify trends and anomalies in reimbursement data to inform strategic decisions.
- Cross-Functional Collaboration
- Serve as a liaison between revenue cycle, managed care, finance, and payer representatives.
- Participate in Joint Operating Committee (JOC) calls with providers and take detailed meeting notes and follow-up actions.
- Provide updates and recommendations to leadership on contractual performance and payer behavior.
- Regulatory Monitoring
- Stay informed on state and federal regulations, payer policy changes, and industry standards.
- Communicate key regulatory updates to internal stakeholders and support compliance initiatives.
- Project Support & Continuous Improvement
- Assist with special projects, including contract modeling and performance improvement initiatives.
- Support quality assurance efforts related to contract modeling tools and reimbursement tracking.
Requirements
- Bachelor’s degree in Business, Health Administration, or related field required.
- 2–4 years of experience in patient accounting, preferably in a hospital or healthcare setting.
- 3+ years of experience with contract analytics, payer reimbursement, or healthcare financial modeling.
- Advanced Excel skills required (pivot tables, formulas, data visualization).
- Familiarity with contract modeling software and hospital billing systems strongly preferred.
- In-depth understanding of the healthcare revenue cycle and third-party reimbursement.
- Strong analytical and problem-solving skills; ability to interpret payment methodologies.
- Excellent written and verbal communication skills, including ability to present complex findings clearly.
- Knowledge of hospital billing practices and compliance standards.
- Strong interpersonal skills and professionalism in cross-functional and payer-facing roles.
- Ability to manage multiple priorities and maintain composure under pressure.
- Integrity and discretion when handling confidential financial data.
Salary: The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.
#LI-NB1
Meet Your Recruiter
Nancy Bookchin
Director, Healthcare Recruitment
Nancy is a dedicated recruiter who prioritizes the success of her clients and the career aspirations of her candidates.
Learn more about Nancy, Tal Healthcare Employee Biography
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Managed Care Analyst
101 East Post Road, 2nd floor , Human Resources White Plains, NY 10601 US
Job Description
Our client, a leading non-profit medical center in Westchester County, is seeking a detail-oriented and analytical Managed Care Analyst to support its growing revenue cycle operations. This role is essential to ensuring accurate reimbursement from third-party payers and maintaining contract compliance. You’ll play a key role in data analysis, contract modeling, audit support, and payer relations—ultimately strengthening the organization’s financial health and operational effectiveness. This is a high-impact role at a mission-driven medical center recognized for its commitment to community health and patient-centered care. You'll be working with an engaged team that values accountability, innovation, and continuous improvement in a collaborative and supportive environment.
Responsibilities
- Contract Analysis & Payment Reconciliation
- Analyze reimbursement data based on contract structure and hospital-negotiated rates.
- Audit and reconcile plan payments to identify and report contract variances.
- Collaborate with payers to resolve discrepancies related to underpayments or non-compliance.
- Maintain escalation files and track outcomes of payer escalations.
- Contract Support & Maintenance
- Assist in testing, validating, and maintaining contract terms and fee schedules in both host systems and contract modeling software.
- Participate in the preparation of contract reference guides and summary documents for distribution across the revenue cycle team.
- Reporting & Data Analytics
- Collect, model, and analyze claims data to support contract negotiations and performance assessments.
- Prepare monthly reports and dashboards to monitor plan performance and financial impact.
- Identify trends and anomalies in reimbursement data to inform strategic decisions.
- Cross-Functional Collaboration
- Serve as a liaison between revenue cycle, managed care, finance, and payer representatives.
- Participate in Joint Operating Committee (JOC) calls with providers and take detailed meeting notes and follow-up actions.
- Provide updates and recommendations to leadership on contractual performance and payer behavior.
- Regulatory Monitoring
- Stay informed on state and federal regulations, payer policy changes, and industry standards.
- Communicate key regulatory updates to internal stakeholders and support compliance initiatives.
- Project Support & Continuous Improvement
- Assist with special projects, including contract modeling and performance improvement initiatives.
- Support quality assurance efforts related to contract modeling tools and reimbursement tracking.
Requirements
- Bachelor’s degree in Business, Health Administration, or related field required.
- 2–4 years of experience in patient accounting, preferably in a hospital or healthcare setting.
- 3+ years of experience with contract analytics, payer reimbursement, or healthcare financial modeling.
- Advanced Excel skills required (pivot tables, formulas, data visualization).
- Familiarity with contract modeling software and hospital billing systems strongly preferred.
- In-depth understanding of the healthcare revenue cycle and third-party reimbursement.
- Strong analytical and problem-solving skills; ability to interpret payment methodologies.
- Excellent written and verbal communication skills, including ability to present complex findings clearly.
- Knowledge of hospital billing practices and compliance standards.
- Strong interpersonal skills and professionalism in cross-functional and payer-facing roles.
- Ability to manage multiple priorities and maintain composure under pressure.
- Integrity and discretion when handling confidential financial data.
Salary: The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.
#LI-NB1
Meet Your Recruiter
Nancy Bookchin
Director, Healthcare Recruitment
Nancy is a dedicated recruiter who prioritizes the success of her clients and the career aspirations of her candidates.
Learn more about Nancy, Tal Healthcare Employee Biography