What are the responsibilities and job description for the USPI Managed Care Operations Analyst (Onsite based in Dallas, TX) position at USPI Staff (Non?
Position to provide critical support for ambulatory surgical center (ASC) and surgical hospital managed care operations. The position will be involved in the day-to-day implementation and maintenance of contract terms in various claims adjudication systems. This team member will work directly with Tenet Managed Care Operations Director and partner with USPI’s Central Billing Office teams and others to provide operational excellence as USPI continues to grow its footprint as the leading national ambulatory surgery management platform.
Responsibilities:
- Loading contract reimbursement terms in various adjudication systems (Cerner, AdvantX, SIS Complete).
- Conduct contract rate audits to ensure adjudication terms are accurately programmed.
- Maintain database of contract terms and action items to ensure systems are updated timely.
- Researches and works out resolution on contract load issues.
- Responsible for the distribution of contracting documents to appropriate parties.
- Communicates contract terms with third party vendors as needed.
- Collaborate and execute special projects and duties as assigned.
- Develop documentation on new and existing analytics processes and workflows.
- Perform additional tasks or responsibilities as required to support business needs.
Qualifications:
- Bachelor’s degree is required. Areas of study include mathematics, statistics, analytics, healthcare administration, business or related field is preferred.
- Must have at least two years of previous experience in financial or operations analysis, preferably in a healthcare provider setting.
- Strong problem solving and analytical skills.
- Demonstrates a high level of critical thinking.
- Well-developed interpersonal and communication skills are essential.
- Advanced knowledge of Microsoft Excel required.
- Familiarity with healthcare reimbursement methodologies and coding (DRG, APC, CPT/HCPCS, ICD-10).
Tenet Healthcare/USPI complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.
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