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Managed Care Analyst

Baptist Health Care

Pensacola, Florida

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JOB DETAILS
SKILLS
Analysis Skills, Communication Skills, Contract Analysis, Contract Management, Diagnosis-Related Group (DRG), Epic Certification, Epic Systems, Fee Schedule, Finance, Finance Software, Financial Analysis, Financial Modeling, Financial Operations, Healthcare, Healthcare Administration, Healthcare Providers, Healthcare Reimbursement, Hospital, Leadership, Managed Care, Medicaid, Medicare, Negotiation Skills, Nonprofit, Orthopedics, Presentation/Verbal Skills, Primary Care, Quality of Life, Reconciliation, Reimbursement, Revenue Management, Sports Medicine, Team Player, Testing, Validation Testing, Variance Analysis, Writing Skills
LOCATION
Pensacola, Florida
POSTED
23 days ago
JOB DESCRIPTION

The Managed Care Analyst supports the financial analysis, modeling, and implementation of managed care contracts within Epic. This role translates contract terms into accurate reimbursement models, evaluates contract performance, and supports payer negotiations through data-driven insights. The position partners closely with Managed Care, Revenue Cycle, Finance, and Epic application teams to ensure contract accuracy, optimal reimbursement, and revenue integrity.

RESPONSIBILITIES

  • Develops and maintains financial models for proposed and existing managed care contracts.
  • Models complex reimbursement methodologies including DRG, APC, per diem, case rates, and fee schedules.
  • Analyzes contract financial impact to support payer negotiations and leadership decision-making.
  • Performs expected vs. actual reimbursement variance analysis.
  • Translates executed contract language into Epic reimbursement contract build.
  • Configures and maintains expected reimbursement and fee schedules in Epic.
  • Performs Epic testing and validation prior to production release.
  • Partners with Epic application teams to resolve reimbursement discrepancies.
  • Monitors managed care contract performance and identify underpayments.
  • Supports audits, reconciliations, and payer disputes.
  • Collaborates with Managed Care, Revenue Cycle, Finance, and Operational teams.
  • Communicates complex reimbursement concepts to non-technical stakeholders.


QUALIFICATIONS

Minimum Education
  • Bachelor's Degree Business, Finance, Health Care Administration, Related field Required or
  • Four years of related experience may be considered in lieu of degree Required

Minimum Work Experience
  • 3 years' Experience in managed care contract modeling or healthcare financial analysis experience. Required
  • 1 year Experience in Epic reimbursement modules. Preferred
  • 1 year Experience supporting payer negotiations and renewals. Preferred
  • 1 year Experience in a multi-facility health system. Preferred
  • 1 year Experience with Medicare, Medicaid, and commercial reimbursement Preferred

Licenses and Certifications
  • Epic certification(s) in relevant modules. Upon Hire Preferred

Required Skills, Knowledge and Abilities
  • Strong understanding of healthcare reimbursement methodologies.
  • Advanced Excel skills.
  • Demonstrated proficiency in reimbursement modules.
  • Knowledge of healthcare revenue cycle operations and workflows.
  • Excellent written and verbal communication skills.
  • Ability to work collaboratively with diverse teams.
  • Strong ability to analyze, interpret, and evaluate data.


ABOUT US

Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includesthree hospitals, four medical parks,Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida.

Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law. Certain positions may require a Level 2 Background check through AHCA. Additional information about this requirement can be found here: Florida Care Provider Background Screening Clearinghouse

About the Company

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Baptist Health Care