Careers

Managed Care Analyst | Full Time | Remote Work Available

Rapid City, SD USA Full time 22_4533

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Current Employees:

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COVID Vaccination Statement

Ensuring the safety and well-being of our patients, visitors, staff, and communities is our deepest commitment at Monument Health. As a condition of employment, Monument Health requires all employees be fully vaccinated * against COVID-19, or have obtained an approved medical or religious exemption, prior to starting employment. 

*Fully vaccinated means it has been at least two weeks since the completion of a COVID-19 primary vaccination series. COVID-19 primary vaccination series is defined as the administration of a single-dose vaccine (such as the Janssen (Johnson & Johnson) COVID-19 Vaccine) or the administration of all required doses of a multi-dose vaccine (such as the Pfizer-BioNTech COVID-19 Vaccine (interchangeable with the licensed Comirnaty Vaccine) or the Moderna COVID-19 Vaccine).

Pay Rate Range

$21.64

to

$27.05

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

It starts with heart. That is what you will do each day. As a Managed Care Analyst with Monument Health, you are an integral part of the Managed Care and Employee Health Plan Administration department. You will discover a culture of teamwork, professionalism, mutual respect, and— most importantly— a life-changing career. You will make a difference. Every day.

You will oversee and manage all payor’s Physician Fee Schedules, provide analytical and technical management to the Revenue Cycle teams to maximize net revenue and facilitate contractual arrangements to provide timely and efficient billing and collection of accounts. You will also provide contract modeling and analysis for physician reimbursement.

Monument Health is located in an outdoor paradise surrounded by mountains, lakes and national forests. Access to outdoor activities such as hiking, kayaking, skiing, snowboarding, mountain biking, boating, water skiing, fishing and so much more makes this area an ideal place to live and work! Rapid City, South Dakota has a small-town atmosphere with access to amenities such as a regional airport and a variety of shopping and dining choices year around!

Our vision at Monument Health is to be one team, to listen, to be inclusive, and to show we care. To do the right thing. Every time. If you share this philosophy, we hope you’ll join us.

Remote workers are hired in these states: Wyoming, Texas, Florida, Georgia, North Carolina, Nebraska, South Carolina, Virginia, Tennessee, Ohio and South Dakota.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)

*Flexible scheduling

Job Description

Essential Functions

  • Oversees and manages physician fee schedules, including acquiring fee schedules from payors and building each within EPIC.  Oversees the auditing, maintenance, and management of Physician Fee Schedules within EPIC. 
  • Develops and maintains business relationships with payors.
  • Oversees and manages escalated claim issues for physician billing.
  • Responsible for preparing and analyzing physician contract modeling.
  • Serves as the primary liaison with payors for concerns related to physicians, including but not limited to:  authorizations, reimbursement issues, provider enrollment and contract compliance.
  • Responsible for identifying and notifying manager of opportunities and threats related to managed care payors and Monument Health’s business and financial objectives. 
  • Understands how the Revenue Cycle and Provider Enrollment system works in order to identify circumstances where there may be opportunities and/or issues.
  • Participates in training sessions as required.
  • Verification and accuracy of data, compiling data and translating data in to useable information.
  • Development and creation of excel, PowerPoint, work flows, and word documents needed by the Managed Care Department.
  • All other duties as assigned.

Additional Requirements

Required

Education - Bachelors in Business Administration/Management, Healthcare Administration, or Related Field

Work Experience - 3+ years Healthcare Experience, 3+ years Project Management Experience, 3+ years Microsoft Office Word Excel and PowerPoint

Preferred

Certifications - Certified Revenue Cycle Specialist Professional (CRCS-P) - American Association of Healthcare Administrative Management (AAHAM), Certified Specialist Managed Care (CSMC) - Healthcare Financial Management Association (HFMA)

Work Experience - 1+ years Credentialing Experience,

Job Category

Revenue Cycle

Job Family

Credit and Collections

Department

CS Managed Care

Scheduled Weekly Hours

40

Shift

Employee Type

Regular

15 Corporate Services Division

Make a differenceEvery day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

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