Job Description - Managed Care Analyst, Hospital Operations
Description
Community Hospital Corporation (CHC) is looking for a Managed Care Analyst that will support the Vice President of Health Plan Contracting, providing analytical and contracting support to the Health Plan Contracting function through health plan contract process management, health plan contract review and negotiation. This position sits at the intersection of healthcare finance, insurance claims operations, and legal contract management.
Community Hospital Corporation (CHC), recently recognized as a 2026 Dallas Morning News Top Workplaces and named to Becker’s list of 165 Top Places to Work in Healthcare. This is an exciting onsite role at our beautiful corporate offices located in Plano between Legacy West and Grandscape. At CHC we enjoy an outstanding work environment, comprehensive health and welfare benefits including paid fitness facility membership, tuition reimbursement, a generous PTO allowance, free covered parking, and a great company culture.
This individual is also responsible for providing analytical support to the CHC Revenue Cycle Team and the CHC affiliated facilities to analyze the patient account receivables (A/R). The position will report directly to the Vice President of Health Plan Contracting.
Major Responsibilities:
Health Plan Contracting
Review health plan contracts and identify desired contract modifications in accordance with CHC contract criteria.
Assist in negotiations with payers regarding terms and rates and prepare contracts for final signature.
Audit payments received from managed care companies to ensure accuracy at each hospital against contract terms.
Assist in the maintenance of various databases of contract information.
Interact with client hospitals and health plan representatives to ensure claims payment accuracy.
Revenue Cycle Analysis
Identify, investigate, and audit claims variances where actual payer reimbursement does not match the expected contractual amount.
Collaborate with the revenue cycle team to resolve complex claims issues and resubmit corrected claims or appeals.
Work in multiple systems for the hospital and clinic settings to provide the support requires the understanding of each facility's financial data points.
Additional responsibilities include supporting the CHC Revenue Cycle team with understanding the functionality of claim systems and the associated analytic tools.
General Duties
Upholds and supports the company’s mission, vision, and values
Perform other miscellaneous job-related duties as assigned by the Vice President of Health Plan Contracting.
Requirements
Education
BBA or BS Degree
Experience
Three - Five or more years experience in healthcare financial operations.
Health plan contracting experience preferred.
Experience working with hospital Electronic Health Records (EHR) and billing systems (e.g., Epic, Cerner, Meditech).
Skills and Knowledge
Ability to define and prioritize specific realistic, goals and objectives
Ability to identify, analyze and effectively resolve operational and administrative problems
Ability to work independently and manage multiple projects simultaneously
Ability to be trustworthy
Ability to professionally and successfully interact with a variety of internal and external parties
Communicates openly and in a timely way
Shares information appropriately
Keeps others well informed
Responds in a timely manner to messages/requests
Knowledge of hospital revenue cycle and the impact of such operations on hospital reimbursement
Knowledge of hospital and physician health plan contracts, and the impact of such contracts on hospital operations
Knowledge of all types of healthcare payer sources such as commercial, governmental, workers compensation and others
Proficient understanding and application of the concepts and terminology unique to the healthcare industry
Medicare and Direct Data Entry (DDE) experience preferred, not required
Understanding of electronic files; 837, 835, 277
Understanding of the complete revenue cycle process and the financial implications.
Understanding of Protected Health Information (PHI), along with HIPAA \ HITECH rules and regulations.
Intermediate level user of Excel and/or Google Sheets
SQL Report Writing Skills preferred
Benefits
At CHC we enjoy an outstanding work environment, covered parking, comprehensive health and welfare benefits including paid fitness facility membership, tuition reimbursement, a generous PTO allowance, and a great company culture. Comprehensive health and welfare benefits package is offered as part of total compensation:
Health Care Plan (Medical, Dental & Vision)
Retirement Plan (401k, IRA)
Life Insurance (Basic, Voluntary & AD&D)
Paid Time Off (Vacation, Sick & Public Holidays)
Wellness Resources and other benefits
CHC is a tobacco and drug free workplace. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
All Job Ads are subject to GrabJobs’s Terms of Service. We allow users to flag postings that may be in violation of those terms. Job Ads may also be flagged by GrabJobs moderation team. However, no moderation system is perfect, and flagging a posting does not ensure that it will be removed.
Be the first to receive the latest Others Full-Time Jobs in the US.
Setup your job alert:
By activating job alerts, I agree to GrabJobs Terms & Privacy Policy. I can unsubscribe to job alerts anytime.
Skip
GrabJobs is the no1 job portal in the US, connecting you to thousands of jobs fast!
Find the best jobs in the US, apply in 1 click and get a job today!