Overview:
Qualifications:
*All positions are located in Fresno/Clovis CA*
Responsibilities:
The Manager of Managed Care Analytics leads the development of actionable models and insights to support payer contract negotiations. This position is responsible for overseeing a team of analysts, ensuring accurate analysis, validation, and loading of payer contracts into the Electronic Health Record (EHR) and contract modeling systems. The role serves as a key liaison to senior leadership, providing critical reporting on payment rates, denial trends and contract compliance.
This leader works in close collaboration with Finance, Patient Financial Services, and Managed Care to address payer-related issues, evaluate service line performance and assess the reimbursement impact of new programs and services.
Education
- Bachelor's Degree in Accounting, Finance, Business Administration, Health Administration, Statistics or a related field required
- Master's Degree in Business Administration (MBA) or a related field preferred
- In lieu of a bachelor’s degree, 15 or more years of progressive experience in Revenue Cycle may be considered
Experience
- 7 years of progressive experience in healthcare analytics, managed care contracting, revenue cycle, or related fields required
- 3 years in a supervisory or management role, with demonstrated experience leading analyst teams and driving cross-functional collaboration required
- Strong background in payer contract analysis, reimbursement methodologies, and healthcare data systems (e.g., EHRs, contract modeling platforms, BI tools) required
- Experience working with both government and commercial payers preferred
Licenses and Certifications
- EPIC - Epic Certification preferred
- HFMA - Healthcare Financial Management Association Certification preferred
- Pay ranges listed are an estimate and subject to change.
- If any bonuses are noted, they are only applicable to external hires meeting criteria.
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