Financial and Contracts Systems Analyst Managed Care
On-site · West Allis, Wisconsin, United States
Job Summary
The Managed Care Financial & Contracts Systems Analyst role maintains the integrity of expected reimbursement calculations within Epic's Professional Billing module by building, maintaining, and optimizing professional billing contracts in the Epic EHR. The position combines Epic build expertise with financial analysis to ensure accurate estimated reimbursement is depicted, supports financial planning for contract negotiations with various financial models, and provides financial analyses that inform strategic initiatives, operational efficiency, and financial sustainability. Requires a Bachelor's degree in a related field or equivalent experience, 2+ years in healthcare finance (or 5+ years with HS Diploma), and familiarity with Medicaid and Commercial payer reimbursement methodologies; Epic PB Contracts experience or certification is preferred or willingness to obtain within one year. Proficiency in data modeling, analysis, and visualization tools is expected, along with strong communication skills and knowledge of healthcare contract terminology and reimbursement models.
Required Qualifications
- Bachelor's Degree in Finance, Healthcare Administration, Business, or related field required or relevant experience
- 2+ years of experience in a healthcare finance-related function OR high school diploma AND 5+ years of experience in a healthcare finance-related function
- Experience in healthcare contract modeling and optimization preferred
- Experience in financial modeling and contract analysis preferred
- Experience with healthcare professional billing and reimbursement methodologies and workflows preferred
- Strong analytical skills with the ability to interpret complex contract language
- Proficiency with data modeling, analysis and visualization tools - including complex formulas and data analysis
- Familiarity with Medicaid and Commercial payer reimbursement methodologies (fee schedules, percent of charge, carve-outs, grouper-based logic)
- Strong written and verbal communication skills
- Epic PB Contracts experience or certification OR willingness to obtain certification within one year of hire
- Understanding of payer contracts and reimbursement models preferred
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