Managed Care Analyst I

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Under direction of the Manager, the Managed Care Analyst I will be responsible for identifying payment variances, collecting underpayments from third party payers, and notifying management when overpayments are detected. Will also be responsible for identifying payment trends, calculating impact and reporting findings to manager. Will interact with Mass General Brigham Finance staff and payor liaisons to understand root causes and make recommendations for resolution that will maximize future reimbursement.

Education

• Bachelor's Degree Related Field of Study required
  

Experience

• Experience in accounting or finance 3-5 years required

• Experience in a role within a large healthcare organization 3-5 years preferred
  

Knowledge, Skills and Abilities

• Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization

• Ability to successfully interact and collaborate with others of different skill sets, backgrounds and levels within and external to the organization

• Knowledge of Third Party billing rules and reimbursement methodologies

• Strong financial analytical, problem solving and negotiation skills

• Ability to effectively conduct meetings, both formal and informal

• Proficient with Excel, Access a plus

• Experience with contract modeling tool (FinThrive or Experian a plus)
  
  

Essential Functions

• Use/s the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration

• Independently and accurately, analyze third party payment variances and determine root causes for discrepancies, utilizing database tools in a timely manner

• Resolve underpayment variances directly with payors when indicated

• Provide qualitative reporting to manager on overpayments

• Provide continuous feedback to manager

• Participate in payor operations and revenue analyses meetings internally and externally as necessary

• Compile summary variance reports for Management

• Act as liaison between Payer Variance team and our zero balance vendors – responsibilities may include, but are not limited to, contract research, payer escalations, invoice management, etc.

• Actively participate in process improvement initiatives including, but not limited to the MGB RCO ‘ESP – Everyone Solves Problems’ initiative

• Other duties as assigned
  

Remote

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$62,400.00 - $90,750.40/Annual

Grade

6

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework