Managed Care Analyst

Overview UTHealth is seeking a Managed Care Analyst to analyze, monitor, and support managed care contracting and reimbursement arrangements for the clinical practice. This role ensures accurate interpretation of payor agreements, supports revenue optimization, and promotes compliance with contractual, regulatory, and organizational requirements. The Managed Care Analyst will play a critical role in evaluating fee schedules, identifying reimbursement variances, and developing scenario models to assess proposed rate changes, policy shifts, and alternative payment structures.

You will need to perform a fee analysis and build Excel models to project the financial impact of complex contract terms. Position Key Accountabilities Analyze managed care contracts and reimbursement methodologies to ensure accurate implementation and ongoing compliance. Monitor contract performance, including reimbursement trends, utilization, and financial impact, and identify variances or potential issues.

Collaborate with billing, finance, compliance, and legal teams to resolve contract-related discrepancies and reimbursement concerns. Maintain and update contract-related data, rate schedules, and analytical reports to support operational and financial decision-making. Evaluate payor performance and prepare summaries or analyses to support contract negotiations, renewals, and strategic planning.

Assist with audits and payor reviews by providing accurate data, analysis, and documentation as requested. Respond to internal inquiries regarding managed care contracts, reimbursement structures, and payor policies in a timely and professional manner. Stay informed of changes in healthcare regulations, payor guidelines, and industry trends that may impact managed care arrangements.

Performs other duties as assigned. Certification/Skills Knowledge of healthcare payor contracts, reimbursement methodologies, and regulatory requirements. Proficiency with data analysis tools, spreadsheets, and Microsoft Office Suite.

Strong analytical skills with the ability to interpret complex contract language and reimbursement data. Attention to detail and accuracy in financial and contract analysis. Ability to manage multiple priorities and deadlines in a fast-paced environment.

Effective problem-solving skills to identify issues and propose solutions. High degree of confidentiality and professionalism when handling sensitive financial and contractual information. Ability to work independently and collaboratively with cross-functional teams.

Strong written and verbal communication skills. EPIC Cogito Certification by EPIC preferred Minimum Education Bachelor's Degree in healthcare administration, business, finance, or a related field required Minimum Experience 3 years of experience in managed care analysis, reimbursement analysis, or SQL, or a minimum of 5 years of experience in accounting, analysis, or financial reporting required Physical Requirements Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects. Security Sensitive This position is a security-sensitive position pursuant to Texas Education Code 51.215 and Texas Government Code 411.094.

To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code, the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant from being able to maintain the security or integrity of the infrastructure. Residency Requirement Employees must permanently reside and work in the State of Texas. #J-18808-Ljbffr