University of Utah Health HP Payer Con Reimburse Analyst in Murray, Utah

Overview:

As a patient-focused organization, the University of Utah Health Care exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health Care seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA

University of Utah Health Plans is committed to transforming health care through innovative initiatives, new provider payment methodologies, thoughtful network analysis and the development of ACOs dedicated to improving the customer experience, increasing quality and reducing costs. Under the direction of the UUHP Provider Contracting Manager, the contract/reimbursement analyst is responsible for analyzing and maintaining provider reimbursement schedules as well as network and provider reporting. This position requires strong analytical skills and independent thinking.

Responsibilities:

  • Review and audit contract terms within 90 days of implementation to ensure accuracy and compliance.

  • Act as the designated liaison for providers and other internal departments regarding payment accuracy.

  • Prepare and monitor Key Performance Indicators (KPIs) for contracts (i.e., top 10 volume, expense).

  • Develop geo-access and other network adequacy reports

  • Create & maintain fee schedules

  • Analyze provider data and generate ad-hoc reports.

Knowledge / Skills / Abilities

  • Strong analytical and problem-solving skills, strong oral and written communication skills and excellent database/modeling skills.

  • Extensive knowledge of provider contract analysis.

  • Industry knowledge of healthcare provider reimbursement methodologies including but not limited to capitation, FFS, per diem, case rate, stop loss, % of billed charges, RVUs, etc..

  • Working knowledge of various healthcare codes such as HCPCS, CPT, DRG, ICD, revenue and others.

Qualifications:

Qualifications

Required

  • Bachelor’s degree in actuarial science, business, economics, finance, mathematics or equivalent healthcare related experience with knowledge of provider contracting analysis/modeling.

Qualifications (Preferred):

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

  • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements:

Listening, Sitting, Speaking, Standing, Walking

Requisition Number 25704

Reg/Temp Regular

Employment Type Full-Time

Shift Day

Work Schedule Days

Location Name University of Utah Health Plans

Patient Care? No

City Murray

State UT

Department UIP CST 01H UUHP PROVIDER SRVC

Category Insurance / Health Plans

The University of Utah Health Care is an Affirmative Action/Equal Opportunity employer. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah Health Care is committed to diversity in its workforce. Women and minorities are encouraged to apply.