Managed Care Contract Analyst

Details

Client Name

Childrens Health System of Texas - TRINITY TOWERS

Job Type

Local

Offering

Non-Clinical

Profession

Professional

Specialty

Finance

Job ID

16916795

Job Title

Managed Care Contract Analyst

Weekly Pay

$1970.0

Shift Details

Shift

Days 5x8

Scheduled Hours

40

Job Order Details

Start Date

09 / 08 / 2025

End Date

12 / 08 / 2025

Duration

13 Week(s)

Job Description

Requires depth within a specialized, critical discipline and / or breadth of substantive professional knowledge that crosses

disciplines within the professional field

Interprets internal / external business challenges and recommends best practices to improve products, processes or services

May lead functional teams or projects with moderate resource requirements, risk, and / or complexity

Leads others to solve complex problems; uses sophisticated analytical thought to exercise judgment and identify innovative

solutions

Impacts the achievement of customer, operational, project or service objectives; work is guided by functional policies

Works independently, with guidance in only the most complex situations

Communicates difficult concepts and negotiates with others to adopt a different point of view

Collaborate with other departments to prioritize and ensure Managed Care contract performance and all related analytic

needs are met for the system. Serve as a mentor to other Analysts on the team and a subject matter expert to other CHST

departments.

Complete financial impact analysis of all contract negotiations, including modeling of contract proposals, reporting of

contract proposal impact, performance and quantifying financial impact of these proposals for future year(s) and developing

alternative proposals within the budget parameters. Present analysis and recommendations to leadership.

Prepare multiple analyses and presentations by extracting data from systems including Crystal, EPIC, STRATA and other

Children's Health Services of Texas (CHST) systems and relational databases utilizing expertise in Excel. Evaluates the need to

create new or modify existing ad hoc and / or customized reports.

Review all Managed Care contracts and amendments as received and complete require system updates, ensuring that all

contracts in EPIC are current and calculating correctly.

Analyze contracts and prepare all supporting schedules necessary to update / maintain the EPIC system on a current basis. This

includes but not limited to : reviewing all new contracts / amendments, meeting with Revenue Cycle staff to review changes,

communicating with the payors to receive all updates on current basis, researching and downloading data form payor sites,

analyzing and comparing new fee schedules to the prior fee schedules, preparing all uploads, validating input and updating

EPIC reimbursement contracts.

Stay abreast of all Texas Medicaid & Healthcare Partnership (TMHP), CMS and other governmental regulation changes that

affect Fee Schedule pricing. Proactively model all changes to fee schedules to determine the financial impact on CHST

revenue and communicate with leadership.

Accountable for the maintenance of the Payor and Plan database in EPIC. Facilitate monthly meetings and seek agreement

before any changes are made. Maintain the synchronization among the service areas. Ensure all plans are mapped to correct

contract in EPIC and facilitate audits, at least on a quarterly basis.

Interprets managed care contract terms and validates understanding with the contract negotiator and model relevant

parameters into contract model application for contracts with annual revenue in excess of $2.3 Billion.

Client Details

Address

2777 N. Stemmons Freeway CMC - TRINITY TOWERS

City

Dallas

State

TX

Zip Code

75201