U.S. Physical Therapy, Inc. ("USPh"), founded in 1990, is a publicly held company that operates 700+ outpatient physical and/or occupational therapy clinics in 44 states. As one of the largest publicly traded, pure-play operators of outpatient physical and occupational therapy clinics, we are currently experiencing an exhilarating period of growth. Our clinics provide pre- and post-operative care for various orthopedic-related disorders and sports-related injuries, rehabilitation of injured workers, and preventative care.
We are currently looking for a Managed Care Analyst to join our team. Reporting to the Director of Managed Care Contracting, you will be responsible for negotiating contracts with managed care companies/health plans and providing advanced analytics to meet the strategic goals for the financial performance of these contracts. You will interact with internal and external parties regarding communication/questions about rates and terms, rate structure, development, and reconciliation of contract provisions and disputes. You will develop, maintain, and provide regular reporting on the financial performance of the contracts for contract monitoring, budget, and long-range planning in support of revenue integrity efforts and for contract department performance and accountability review.
Responsibilities:
- Interprets managed care contracts and government reimbursement methodologies to create contract modeling calculations
- Prepare pre-negotiation analysis to support development of negotiation strategies
- Define, develop, and execute modeling and analysis for new and updated fee schedules and contracts
- Manage contract records in Managed Care Contracting’s database and in other tools to provide timely updates to staff throughout provider organizations. Stay abreast of renewals, amendments, and other contract changes
- Query EMR and Practice Management Systems to obtain data for accurate analysis
- Assist Reimbursement on more complex projects, providing support as necessary
- Assist in creating new modeling templates and analysis for the Managed Care Operations Team
- Work with contracted parties to determine the nature of contract language misunderstandings and resolve conflicts efficiently and fairly to all parties involved
Requirements
- A bachelor's degree in business administration or health care administration is preferred, or equivalent experience
- 4+ years of overall work experience, 2+ years of analytic work experience in the healthcare industry.
- Must have extensive experience and knowledge of healthcare reimbursement methodologies and concepts.
- Substantial knowledge of payer credentialing
- Proficiency in performing financial impact analysis, impact modeling, predictive modeling, and data manipulation.
- Advanced experience with Excel, including large data sets, creating advanced reports, utilizing look-up formulas, creating pivot tables, and utilizing advanced functions/formulas
- Possess an understanding of Medicaid and Medicare programs and payor contract language.
- Ability to work independently with minimal supervision, plan, organize, prioritize assignments and responsibilities and time constraints in a fast-paced environment and adapt to them as they change frequently
What You'll Get:
- Competitive compensation.
- Excellent benefits
- Generous paid time off with holidays
- Continuous mentoring to further your career path
- Investment from a company that wants you to succeed and thrive
- Great close-knit team environment. We work hard, but we have fun!
Other Information
This position's anticipated base salary range is $75,000- $85,000. Salary is based on various factors, including relevant experience, knowledge, skills, other job-related qualifications, and geography. Additionally, this position is eligible for discretionary incentive compensation. The company's incentive compensation plan is subject to change. Medical, dental, vision, 401(k), paid time off, and other benefits are available.
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