Manager Managed Care Analytics - PFS
Overview
*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.Qualifications
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 preferredDisclaimers
• Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.
Average salary estimate
If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.
Vizient is hiring an AI/ML Analyst to interpret machine learning outputs and develop data-driven strategies that enhance business outcomes in healthcare.
DigitalOcean is looking for a Revenue Analytics Manager to deliver actionable data insights that catalyze growth and support revenue initiatives in a dynamic remote role.
Seeking a Sr. Analyst in Commerce & Growth Product Analytics at NBCUniversal to leverage data insights for optimizing acquisition and subscription growth.
Seeking a detail-oriented Data Analyst to manage and optimize workforce access data within U.S. Bank's IAM systems, supporting secure and efficient financial operations.
Lead complex regulatory data initiatives as a Principal Data Analyst in a hybrid role within a well-established financial services company.
NBCUniversal seeks an experienced Lead for Commerce & Growth Product Analytics to drive data-driven insights and growth across its media product platforms.
Lead the development of AI value assessment methodologies at ServiceNow, helping the enterprise quantify and maximize AI-driven business outcomes.
A fully remote Data Analyst role at Guidehealth leveraging healthcare data and analytics to drive impactful patient and provider outcomes.
A Senior Data Systems Analyst role at AssistRx focused on onboarding trading partners and resolving data quality issues for healthcare clients.
Lead Comcast’s data and reporting team within Impact & Inclusion to enhance philanthropic strategies and community investment insights.
Experienced Federal Data Analyst with active Top Secret clearance needed for data evaluation and document review in Linthicum, Maryland.
The University of Miami is looking for a Data Analyst 1 to analyze data, maintain databases, and contribute to planning initiatives.
Senior Business Optimization Consultant needed at a major U.S. insurer to develop predictive models and dashboards driving data-informed strategy in a bilingual, global environment.
Community Health System is a private, not-for-profit, health system that employs more than 10,000 people. We've grown a lot since 1897 and we're not done yet. We're on a path toward becoming the model for excellence in healthcare, locally and nati...
52 jobs
🔮
Hi, I'm Risa! Your AI Career Copilot
you, just ask me below!
