Job Summary:
Provides advanced financial analysis and decision-support related to managed care contracts, reimbursement methodologies, and payer performance. This role supports Managed Care leadership, Financial Services, and operational departments by analyzing data, modeling financial impacts, preparing reports, and assisting with the evaluation and monitoring of managed care agreements. The position also supports budgeting, forecasting, and strategic initiatives that impact reimbursement and contract performance.
Job Responsibilities:
Performs statistical, cost, and financial analysis of data to evaluate managed care contract performance, reimbursement methodologies, and revenue impacts.
Analyzes and monitors financial aspects of existing managed care agreements, identifying trends and providing recommendations for renewals, renegotiations, or participation decisions.
Prepares financial reports, forecasts, and modeling related to payer reimbursement, provider contracts, profitability, and health care cost trends.
Supports the development, evaluation, and implementation of managed care contracts and reimbursement structures in collaboration with Managed Care leadership.
Assists in loading and maintaining contract terms, rates, and fee schedules within financial and decision-support systems.
Collaborates with clinical, administrative, and financial departments to communicate contract details, address operational issues, and support decision‑making.
Monitors payer performance and payer contract compliance, regulatory changes, and marketplace developments affecting reimbursement.
Researches and analyzes payer trends, providing data‑driven insights for leadership presentations, committees, and strategic planning.
Performs special projects, financial research, and forecasting assignments as needed, ensuring quality and timely deliverables.
Proofreads, redlines, edits, and formats managed care contracts, exhibits, and amendments.
Ensures accurate distribution of executed agreements, exhibits, fee schedules, and operational updates.
Maintains accurate and organized electronic repositories of all contracts, fee schedules, participation information, and payer correspondence.
Tracks all contract activity, effective dates, renewal cycles, term notifications, redline versions, and implementation timelines.
Maintains positive and professional working relationships with payer contacts, ensuring timely, organized, and clear communication.
Facilitates or supports payer operational meetings, including developing agendas, preparing meeting packets, taking minutes, and tracking follow‑up actions.
Supports Managed Care leadership with committee preparation, meeting coordination, presentations, and follow-up tracking.
Skills and Attributes:
Requires critical thinking skills and decisive judgment.
Works under general supervision.
Must be able to work in a stressful environment and take appropriate action.
Requires a strong understanding of the specialized concepts, practices, and procedures in the area of specialization.
Position Requirements:
Work Experience
A minimum of 2 years' relevant experience required
Education
Bachelor's degree or higher in Accounting, Business Administration, Finance or related field as determined by the organization required upon hire.
Additional Education Information
A combination of education, training and experience may be considered in lieu of degree.
Licensure/Certification/Registration
No licensure/certification/registration required
Organizational Responsibilities:
Supports Owensboro Health’s Mission, Vision, Core Commitments, and business interests. Adheres to all organizational policies and procedures. Executes all tasks and behaves in a manner consistent with a culture of compliance, safety and a high reliability organization.
Additional Job Information:
This job description describes the general nature and level of work required by the position. It is not intended to be an all-inclusive list of qualifications, skills, duties, responsibilities or working conditions of the job. Specific duties and responsibilities consistent with the general nature and level of work described may vary by department and additional related duties may be assigned as needed. Some duties listed may not apply to all employees with this job description.
The job description is subject to change with or without notice, and Management reserves the right to add, modify or remove any qualification or duty. Nothing in this job description changes the existing at-will employment relationship between the Organization and the employee occupying the position.
Standard ADA Settings:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical Demands: (Office Environment)
Standing: Occasionally
Walking: Occasionally
Sitting: Frequently
Lifting 0-25 lbs.: Rarely
Lifting 25-75 lbs.: Rarely
Lifting over 75 lbs.: Rarely
Carrying 0-25 lbs.: Rarely
Carrying 25-75 lbs.: Rarely
Carrying over 75 lbs.: Rarely
Pushing/Pulling 0-25 lbs.: Frequently
Pushing/Pulling 25-75 lbs.: Rarely
Pushing/Pulling over 75 lbs.: Rarely
Climbing: Rarely
Bending/Stooping: Rarely
Kneeling: Rarely
Crouching/Crawling: Rarely
Reaching: Occasionally
Talking: Frequently
Hearing: Frequently
Repetitive Foot/Leg Movements: Rarely
Repetitive Hand/Arm Movements: Frequently
Keyboard Data Entry: Frequently
Running: Rarely
Vision: Depth Perception: Frequently
Vision: Distinguish Color: Frequently
Vision: Seeing Far: Frequently
Vision: Seeing Near: Frequently
Hazardous Drug Risk Exposure:
Risk Level: No-Risk
Owensboro Health Core Commitments
INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.
RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.
TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.
INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.
SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.
EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.