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Managed Care Analyst
Utaustin · AUSTIN, TX
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Job Posting Title: Managed Care Analyst ---- Hiring Department: Dell Medical School ---- Position Open To: All Applicants ---- Weekly Scheduled Hours: 40 ---- FLSA Status: Exempt from FLSA ---- Earliest Start Date: Immediately ---- Position Duration: Expected to Continue ---- Location: AUSTIN, TX ---- Job Details: PURPOSE The Managed Care Analyst plays a pivotal role in driving strategic decision-making across the health system by capturing, transforming, interpreting, and presenting complex healthcare data. This position leads analytics related to payer contracting, payment modeling, and revenue cycle key performance indicators (KPIs), providing critical insights that support successful contract negotiations and ongoing payer performance monitoring. Reporting to the Assistant Director of Managed Care Contracting, the Analyst partners with teams across Revenue Cycle, Finance, Clinical Operations, and Executive Leadership. Leveraging advanced data tools and EMR systems, the Analyst delivers actionable intelligence that enhances financial outcomes, operational efficiency, and patient access to care. RESPONSIBILITIES Leads Payment Modeling and Contract Analytics
- Models commercial and government payment methodologies for physician, ambulatory, and hospital services.
- Analyzes contract proposals using reimbursement methods such as fee schedules, DRG, case rates, and stop-loss.
- Leverages tools like Experian MPV and FinThrive for enhanced contract modeling.
- Synthesizes contract terms to support negotiation strategies.
- Evaluates contract performance and compliance. Transforms Data into Strategic Insights
- Extracts and interprets data from EMRs (e.g., Epic, Athena) and financial systems.
- Develops dashboards and reports for Managed Care, Revenue Cycle, and Executive stakeholders.
- Identifies risks and opportunities in payer performance and reimbursement.
- Synthesizes complex datasets into actionable recommendations.
- Supports strategic initiatives with data-driven insights. Analyzes Revenue Cycle KPIs
- Monitors key performance indicators related to claims, denials, and payments.
- Identifies trends in overpayments, underpayments, and global denials.
- Collaborates with Revenue Cycle teams to resolve payer issues.
- Uses EMR reporting capabilities to enhance decision-making.
- Supports compliance and audit readiness. Communicates Effectively with Stakeholders
- Prepares and presents findings to department and executive leadership.
- Translates complex analytics into clear, actionable insights.
- Serves as liaison between internal teams and external payers.
- Participates in cross-functional meetings and payer summits.
- Supports education and training on managed care analytics. Maintains Industry Knowledge and Adapts to Change
- Monitors changes in reimbursement models and payer policies.
- Conducts market research on healthcare trends and regulations.
- Attends professional development events and webinars.
- Evaluates emerging technologies and analytics tools.
- Adapts to evolving payer environments and contract structures. Supports System Enhancements and Upgrades
- Represents department needs in EMR system maintenance and upgrades.
- Collaborates with IT and vendor teams to optimize reporting tools.
- Tests and validates system changes related to managed care analytics.
- Documents system requirements and workflows.
- Provides feedback for continuous improvement. REQUIRED QUALIFICATIONS:
- Bachelor's Degree in Data Science, Analytics, Health Administration, Public Health, Finance, or a related quantitative or healthcare discipline
- At least 4 year(s) of experience in managed care analytics, healthcare finance, payer contracting or a related field.
- Advanced knowledge of commercial and government reimbursement, managed care contracting, fee schedules, revenue cycle management, and EMR software systems such as Epic. Relevant education or experience may be substituted as appropriat e. PREFERRED QUALIFICATIONS:
- Master's Degree in Health Administration, Public Health, Business, or Data Analytics with at least 7 year(s) of experience in managed care analytics or contract negotiation.
- Experience in academic medical center or large integrated health system.
- Certified Professional in Healthcare Quality (CPHQ)
- Certified Health Data Analyst (CHDA) •
Ncqa Hedis
Compliance Auditor (CHCAA)
- Project Management Professional (PMP)
Salary Range
$63,334 + depending on qualifications According to Executive Order No. GA-48 of the State of Texas: for all positions that research, work on, or have access to critical infrastructure as defined in Section 117.001(2), Business and Commerce Code, it is required that both candidates for employment and employees have the ability to maintain the security or integrity of the infrastructure.
Working Environment/equipment
- Standard office equipment
- Repetitive use of a keyboard
- May be exposed to such occupational hazards as communicable diseases, blood borne pathogens, ionizing and non-ionizing radiation, hazardous medications and disoriented or combative patients, or others. Required Materials
- Resume/CV
- 3 work references with their contact information; at least one reference should be from a supervisor
- Letter of interest Important for applicants who are NOT current university employees or contingent workers: You will be prompted to submit your resume the first time you apply, then you will be provided an option to upload a new Resume for subsequent applications. Any additional Required Materials (letter of interest, references, etc.) will be uploaded in the Application Questions section; you will be able to multi-select additional files. Before submitting your online job application, ensure that ALL Required Materials have been uploaded. Once your job application has been submitted, you cannot make changes. Important for Current university employees and contingent workers: As a current university employee or contingent worker, you MUST apply within Workday by searching for Find UT Jobs. If you are a current University employee, log-in to Workday, navigate to your Worker Profile, click the Career link in the left hand navigation menu and then update the sections in your Professional Profile before you apply. This information will be pulled in to your application. The application is one page and you will be prompted to upload your resume. In addition, you must respond to the application questions presented to upload any additional Required Materials (letter of interest, references, etc.) that were noted above. ---- Employment Eligibility: Regular staff who have been employed in their current position for the last six continuous months are eligible for openings being recruited for through University-Wide or Open Recruiting, to include both promotional opportunities and lateral transfers. Staff who are promotion/transfer eligible may apply for positions without supervisor approval. ---- Retirement Plan Eligibility: The retirement plan for this position is Teacher Retirement System of Texas (TRS), subject to the position being at least 20 hours per week and at least 135 days in length. ---- Background Checks: A criminal history background check will be required for finalist(s) under consideration for this position. ---- Equal Opportunity Employer: The University of Texas at Austin, as an equal opportunity/affirmative action employer , complies with all applicable federal and state laws regarding nondiscrimination and affirmative action. The University is committed to a policy of equal opportunity for all persons and does not discriminate on the basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, or veteran status in employment, educational programs and activities, and admissions. ---- Pay Transparency: The University of Texas at Austin will not discharge