Contract Analyst

About the Role

This is a Work from Home position requiring the employee to live within 60 miles of an HCA Healthcare Hospital.

Key Responsibilities

• Model managed care contracts using available modeling tools.
• Ensure accurate discounts on patient accounts and proper reflection of expected net revenue.
• Complete testing of contract models by service line and document accuracy in modeled results.
• Perform prospective ("what-if") financial modeling to evaluate proposed managed care contract terms and assess their impact on reimbursement, profitability, trends, and other key financial metrics.
• Develop and maintain contract models used to evaluate reimbursement methodologies, support managed care agreements, analyze financial impact, and ensure accurate implementation and ongoing maintenance of contract terms.
• Translate contract language and reimbursement methodologies into accurate system models that support operational reimbursement and contract negotiations.
• Accurately apply service descriptions, service rules, reimbursement logic, and modeling parameters to ensure contract integrity and consistency.
• Perform quality assurance reviews of contract model changes related to rates, factors, and reimbursement methodologies to ensure modeling accuracy, consistency, and compliance with established standards.
• Design, develop, and support ad-hoc analyses and reporting initiatives as assigned by leadership.
• Utilize data mining and reporting tools to fulfill customer requests and support operational and strategic initiatives.
• Monitor the progress of pricing analyses and contract modeling activities, keeping management informed of project status, risks, and outcomes.
• Collaborate with Payer Contracting, Revenue Cycle, Finance, and operational stakeholders to resolve contract questions and provide analytical support during contract negotiations and implementation.
• Develop responsive relationships with internal customers by providing timely, accurate analyses and maintaining a high level of customer service.
• Participate in departmental training and professional development opportunities to enhance technical, analytical, and industry knowledge.
• Contribute to continuous process improvement initiatives that increase modeling accuracy, operational efficiency, and reporting capabilities.
• Demonstrate commitment to organizational Mission, Values, and Code of Conduct while producing high-quality, accurate work.

Requirements & Tech Stack

• Working knowledge of managed care contracting, reimbursement methodologies, and contract modeling preferred.
• Experience with Microsoft Office, Excel, relational databases, reporting tools, and contract modeling applications preferred.

Qualifications

• Bachelor’s Degree or Undergraduate Degree Required. Equivalent work experience may substitute for education requirements.
• Minimum 1+ years of related experience preferred.