JOB SUMMARY

Under the direction of the Information Technology Director the Managed Care Analyst II (provider/vendor maintenance) will maintain responsibility for the analysis, modeling, interpretation and loading of healthcare/managed care contractual agreements for primary care, ancillary, specialist and facility providers/vendors into our corporate management software system (currently the EZ-Cap software solution). Managed Care Analyst II will also provide eligibility and benefits analysis, including evaluation and maintenance of EZ-Cap database.

QUALIFICATIONS

Minimum three (3) years of general managed care experience, experience in a health care organization or any combination of academic education, professional training or work experience. Knowledge of health plan Division of Financial Responsibility (DOFR) matrices Knowledge of managed care professional and institutional contracts Working knowledge of professional and institutional claim formats Working knowledge of Microsoft business software ( Excel, Word, Access) SKILLS Must have effective communication, facilitation, interpersonal and professional diplomacy skills. Strong attention to detail with ability to manage multiple priorities while meeting deadlines. Able to Problem-solve, negotiate and demonstrate independent decision-making. Strong communication skills in both oral and written form. Positive attitude and takes a team approach to management. Familiarity with EZ-Cap and Microsoft applications, which include the ability to learn new computer systems and applications. Detail oriented with desire for producing work with 100% accuracy. Excellent problem-solving skills. Ability to read, analyze, and interpret general business periodicals, technical procedures, or government regulations Ability to review and interpret professional and institution contractual agreements , including LOAs /MOUs Working knowledge of professional and institutional claim formats Working knowledge of

CPT , HCPCS

, Revenue, ICD10 code sets As an Equal opportunity employer, DBA Choice Medical Group is committed to a diverse workforce. Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin gender, age sexual orientation, physical or mental disability, genetic information or characteristic, gender identity, and expression, veteran status, or other non-job related characteristics or other prohibited grounds specified in applicable federal, state and local laws. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact this post for assistance. For more information about equal employment opportunity protections, please view the 'EEO is the Law' poster.

NOTICE:

EMPLOYEE POLYGRAPH PROTECTION ACT YOUR RIGHTS UNDER THE FAMILY AND MEDICAL LEAVE ACT PAY TRANSPARENCY NONDISCRIMINATION PROVISION

Our environment respects individual differences and recognizes each employee as an integral member of our company. Our workforce reflects these values and celebrates the individuals who make up our growing team. Choice Medical Group provides a work environment free of harassment and prohibited conduct. We promote and support individual differences and diversity of thoughts and opinion.

Job Type:

Full-time Pay:

$25.00 - $38.75 per hour

Work Location:

In person