Managed Care Analyst

UTHealth is seeking a Managed Care Analyst to analyze, monitor, and support managed care contracting and reimbursement arrangements for the clinical practice. This role ensures accurate interpretation of payor agreements, supports revenue optimization, and promotes compliance with contractual, regulatory, and organizational requirements. The Managed Care Analyst will play a critical role in evaluating fee schedules, identifying reimbursement variances, and developing scenario models to assess proposed rate changes, policy shifts, and alternative payment structures. You will need to perform a fee analysis and build Excel models to project the financial impact of complex contract terms.

We prefer candidates who have worked with Epic, particularly in the reporting areas that utilize Cogito. You will need to have financial acumen, strong analytical skills, and the ability to synthesize complex data and large datasets into clear, actionable insights. This is a role that requires strong problem-solving and critical thinking skills, as well as a working knowledge of healthcare billing and financial data.

What we do here changes the world. UTHealth Houston is Texas’s resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.

Once you join us, you won't want to leave. It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus:

• 100% paid medical premiums for our full-time employees
• Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equate to around 37-38 days per year)
• The longer you stay, the more vacation you’ll accrue!
• Longevity Pay (Monthly payments after two years of service)
• Build your future with our awesome retirement/pension plan!

We take care of our employees! As a world-renowned institution, our employees’ well-being is important to us. We offer work/life services such as...

• Free financial and legal counseling
• Free mental health counseling services
• Gym membership discounts and access to wellness programs
• Other employee discounts, including entertainment, car rentals, cell phones, etc.
• Resources for child and elder care
• Plus many more!

Position Key Accountabilities:

• Analyze managed care contracts and reimbursement methodologies to ensure accurate implementation and ongoing compliance.
• Monitors contract performance, including reimbursement trends, utilization, and financial impact, and identifies variances or potential issues.
• Collaborates with billing, finance, compliance, and legal teams to resolve contract-related discrepancies and reimbursement concerns.
• Maintains and updates contract-related data, rate schedules, and analytical reports to support operational and financial decision-making.
• Evaluates payor performance and prepares summaries or analyses to support contract negotiations, renewals, and strategic planning.
• Assists with audits and payor reviews by providing accurate data, analysis, and documentation as requested.
• Responds to internal inquiries regarding managed care contracts, reimbursement structures, and payor policies in a timely and professional manner.
• Stays informed of changes in healthcare regulations, payor guidelines, and industry trends that may impact managed care arrangements.
• Performs other duties as assigned.

Certification/Skills:

• Knowledge of healthcare payor contracts, reimbursement methodologies, and regulatory requirements.
• Proficiency with data analysis tools, spreadsheets, and Microsoft Office Suite.
• Strong analytical skills with the ability to interpret complex contract language and reimbursement data.
• Attention to detail and accuracy in financial and contract analysis.
• Ability to manage multiple priorities and deadlines in a fast-paced environment.
• Effective problem-solving skills to identify issues and recommend solutions.
• High degree of confidentiality and professionalism when handling sensitive financial and contractual information.
• Ability to work independently and collaboratively with cross-functional teams.
• Strong written and verbal communication skills.
• Work may involve handling biohazardous, chemical, and radiological materials, as well as operating associated equipment. Required safety training and appropriate engineering and administrative controls including the use of personal protective equipment must be followed.
• EPIC Cogito Certification by EPIC preferred

Minimum Education:

Bachelor's Degree in healthcare administration, business, finance, or a related field required

Minimum Experience:

3 years of experience in managed care analysis, reimbursement analysis, or SQL, or a minimum of 5 years of experience in accounting, analysis, or financial reporting required

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:

This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.

Residency Requirement:

Employees must permanently reside and work in the State of Texas.