Reimbursement Specialist (Managed Care)

Shift:Monday-Friday 8:00am - 5:00pm
Department: Managed Care Contracting
Compensation:

* Base Pay Range: $52,665.60 - $83,179.20 per year, based on experience

ABOUT THE JOB

MU Health Care is looking for a sharp, innovative, and detail-driven professional who thrives on transforming complex data into meaningful insights that drive smart business decisions. The ideal candidate is intellectually curious, analytical, and passionate about solving challenges that shape the financial health of a leading academic health system. You bring both precision and creativity to your work-able to navigate intricate data models while keeping a strategic eye on the big picture. Collaboration energizes you, and you take pride in translating numbers into stories that empower leaders to make impactful choices. If you're motivated by continuous improvement, enjoy mastering cutting-edge systems, and want to play a vital role in advancing the mission of MU Health Care, we invite you to join our team and make your mark.

ABOUT MU HEALTH CARE

MU Health Care is proud to be named one of Forbes' Best-in-State Employers seven years in a row, and that's largely a result of the incredible culture and team we've built. At MU Health Care, we have an inspired, hard-working and collaborative environment driven by our mission to save and improve lives. Here, we believe anything is possible and rally around solutions. We celebrate innovation and offer opportunities to be a part of something bigger - to have a voice and role in the work that is serving our community and changing the field of medicine.

Our academic health system - the only in mid-Missouri - is home to seven hospitals, including the region's only Level 1 Trauma Center and region's only Children's Hospital, as well as over 90 specialty clinics. Here you can define your career among our many clinical and nonclinical positions - with growth, opportunity and support every step of the way.

Learn more about MU Health Care.

Learn more about living in mid-Missouri.

EMPLOYEE BENEFITS

* Health, vision and dental insurance coverage starting day one

* Generous paid leave and paid time off, including nine holidays

* Multiple retirement options, including 100% matching up to 8%and full vesting in three years

* Tuition assistance for employees (75%) and immediate family members (50%)

* Discounts on cell phone plans, rental cars, gyms, hotels and more

* See a comprehensive list of benefitshere.

DETAILED JOB DESCRIPTION

Responsible for financial modeling and analysis of all managed care payment proposals. This includes preparation of contract history and performance reports, contract segmentation analysis, impact reports of various contract structures and rates, and consultation of key reimbursement drivers in the models to assist in contract negotiation process.

Responsible for creating and managing facility contract models within the Decision Support/Contract Management system. This includes implementing final negotiated rates in the decision support/contract management system, updating the contract for fee schedule updates, performing other ongoing maintenance to ensure accurate expected reimbursement calculations.

Key team member in the overall management of Decision Support/Contract Management System; this includes participating in decisions regarding installations, upgrades, testing and maintenance. Provides input to the vendor about functional design, data components, and other parameter and use that impact the efficiency and accuracy of the modeling tools.

Produces monthly and complex quarterly managed care/payor report that include payor performance, payor mix, payor trends, service line analysis, and business trend analysis.

Develops and provides ad-hoc reporting for special data accumulations, studies, and projects requested by internal management or other external sources as necessary.

Projects include but are not limited to: payor contract summary detail information for bond rating requests, preparation of year-end contractual allowance estimates for various third-party payors, and support for Center of Excellence surveys.

REQUIRED QUALIFICATIONS

Bachelor's degree is required, preferably in Business Administration, Information Technology, Finance or Statistics.

Requires five or more years experience in hospital contract financial analysis or hospital finance; including a thorough understanding of payor contracts, payor reimbursement, payor manuals, and reimbursement policies.

Experience within an academic medical center is highly desirable.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met with or without reasonable accommodation. The performance of these physical demands is an essential function of the job. The employee may be required ambulate, remain in a stationary position and position self to reach and/or move objects above the shoulders and below the knees. The employee may be required to move objects up to 10 lbs.

The University of Missouri is an Equal Opportunity Employer.