NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute designated comprehensive cancer center, and NYU Grossman School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. At NYU Langone Health, equity, diversity, and inclusion are fundamental values. We strive to be a place where our exceptionally talented faculty, staff, and students of all identities can thrive. We embrace diversity, inclusion, and individual skills, ideas, and knowledge. For more information, go to nyulangone.org, and interact with us on LinkedIn, Glassdoor, Indeed, Facebook, Twitter, YouTube and Instagram.
Position Summary:
We have an exciting opportunity to join our team as a Contract Analyst (Managed Care).
In this role, the successful candidate as the Contract Analyst is responsible for organizing and reviewing financial and utilization data and hospital billing data. This position is responsible for creating and analyzing profit and loss reports and other managed care reports from the cost accounting system. The incumbent will create managed care reports with detailed financial utilization data from other data sources. Additional responsibilities include reviewing all managed care contracts and addressing changes that impact these contracts, validation of contract compliance and other provisions of managed care.
Job Responsibilities:
1. Demonstrates knowledge of the organizations Core Values and incorporates them into the performance of duties.
2. Organizes and reviews financial and utilization data, including insurer claims, eligibility, hospital billing data, payors physician fee schedules and Medicare RBRVS fee schedule.
3. Reviews all managed care contracts; provides analytical support regarding changes impacting contracts, validation of contract compliance and other provisions of managed care.
4. Uses EPSI reporting capability of the hospital decision support system to create managed care reports and to generate and analyze profit and loss reports on individual contracts.
5. Uses Business objects to run detailed charge level data to accurately model contracts during rate negotiations or identify underpayments issues.
6. Assists with loading, auditing and maintaining of payor and physician contracts in EPSI contract modeler in addition to auditing payor contracts loaded in EPIC patient billing system.
7. Prepares managed care reports with detailed financial utilization information on a fee-for-service basis by payer, provider type and by specialty.
8. Provides assistance to Hospital Finance Department to support financial management and evaluation of fee for service hospital contract and identify methods for improving report efficiency. As well as the FGP and other Hospital department ad hoc reporting.
9. Monitors and tracks ongoing claims resolution activities and other practice or hospital service issues that impact reimbursement. Provides log-in access to payor websites by request.
10. Assist Managed Care analytics with Contract modeling on a payor by payor basis.
11. Perform tasks related to pricing transparency and other government regulatory requirements
12. Reviews and identifies yearly CPT coding changes and impact on current contracts
Minimum Qualifications:
Bachelors degree in Business Administration or relevant discipline and 1-2 years relevant experience or an equivalent combination of education and experience. Proficiency using relational databases, database concepts and software applications; must have MS Access and Excel knowledge. Excellent interpersonal and presentation skills. Knowledge of healthcare terms and reimbursement methodologies. Strong analytical and problem solving skills
Preferred Qualifications:
Preferred Qualifications:Familiarity with Crystal/EPSi reporting and EPIC..
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal "EEO is the law" poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.
NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $67,771.14 - $90,535.23 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.
To view the Pay Transparency Notice, please click here