About the role
%3Cp class=%22MsoNormal%22 style=%22text-align:center;%22%3E%3Cstrong%3EContracts Payor Analyst%3C/strong%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22text-align:center;%22%3E%3Ci%3E%3Cstrong%3EBring your passion to Texas Health so we are Better + Together%3C/strong%3E%3C/i%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3EWork Location:%26nbsp;Texas Health Corporate, 612 E. Lamar Blvd., Arlington, TX 76011%3C/strong%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3EWork Hours:%26nbsp;Full Time Days: (8:00am-5:00pm) for 40 hrs/week (Hybrid work allowed at manager%27s discretion)%3C/strong%3E%3C/p%3E%3Cp class=%22MsoNormal%22%3E%3Cstrong%3EDepartment Highlights:%3C/strong%3E%3C/p%3E%3Cul style=%22margin-top:0in;%22 type=%22disc%22%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cstrong%3EHybrid Position%3C/strong%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cstrong%3EGain a sense of accomplishment by contributing to a teamwork environment.%3C/strong%3E%3C/li%3E%3Cli class=%22MsoNormal%22 style=%22mso-list:l0 level1 lfo1;tab-stops:list .5in;%22%3E%3Cstrong%3EReceive excellent mentorship, comprehensive training, and dedicated leadership resources.%3C/strong%3E%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EWhat You Will Do:%26nbsp;%3C/strong%3E%3C/p%3E%3Cp%3EContract Analysis and Audit:%3Cbr%3E%3Cbr%3E. Validate all payor contract loads, ensuring accurate reimbursement methodologies, escalator terms, carve-outs, and fee schedules across EPIC, StrataJazz, PMMC, and related tools.%3Cbr%3E. Conduct comprehensive contract load audits and identify discrepancies between negotiated terms and system configuration.%3Cbr%3E. Perform expected-to-actual reimbursement analysis by payor, entity, service line, and claim type.%3Cbr%3E. Identify and quantify variances; conduct root-cause analysis for underpayments, overpayments, or contract misinterpretation.%3Cbr%3E. Partner with Revenue Cycle and Payor Operations to validate underpayment trends and reconcile discrepancies.%3Cbr%3E. Maintain databases and reporting structures to support continuous monitoring of contract compliance and financial outcomes.%3Cbr%3E. Ensure data integrity and compliance with regulatory and THR data governance standards.%3Cbr%3E. Deliver actionable insights by analyzing historical claims data, reimbursement trends, and competitive market dynamics to inform enterprise pricing strategy for hospitals, ancillaries and physicians.%3Cbr%3E. Prepare dashboards and reports to support executive decision-making, including payor performance, service line, variance analysis, reimbursement trends, and pricing performance metrics.%3Cbr%3E. Prepare monthly/quarterly/annual net revenue reports; identify and report on exceptions.%3Cbr%3E40%%3Cbr%3EContract Support and Payor Operations:%3Cbr%3E%3Cbr%3E. Monitor and report payor performance metrics, including reimbursement variance, contract yield, denial trends, and financial impact.%3Cbr%3E. Track payor policy, regulatory updates, and operational requirements that affect payment performance or reimbursement calculations.%3Cbr%3E. Collaborate with Payor Operations, Strategic Pricing, Revenue Cycle, ITS and SWHR to ensure accurate implementation of economic terms and rate changes.%3Cbr%3E. Support internal audits, compliance reviews, and pricing validations related to reimbursement accuracy.%3Cbr%3E. Participate in six-month lookback audits in partnership with Contract Compliance Auditors.%3Cbr%3E. Provide analytical support for operational issue resolution, contract interpretation questions, and payor escalations.%3Cbr%3E. Ensure compliance with industry regulations and Texas Health policies related to payor pricing.%3Cbr%3E40%%3Cbr%3EStrategic and Special Projects:%3Cbr%3E%3Cbr%3E. Support strategic pricing initiatives, service-line analysis, margin optimization, value based care, and market competitiveness reviews.%3Cbr%3E. Build and maintain dashboards visualizing payor performance, reimbursement variance, and trend analysis for leadership.%3Cbr%3E. Support modeling for new services, alternative payment models, bundled arrangements, and pricing recommendations.%3Cbr%3E. Assist with executive-level presentations, reporting, and strategic planning deliverables.%3Cbr%3E. Complete additional projects and duties as assigned.%3Cbr%3E20%%3Cbr%3E0%%3C/p%3E%3Cp%3E%3Cstrong%3EWhat You Need:%26nbsp;%3C/strong%3E%3C/p%3E%3Cp%3E%3Cstrong%3EEducation%3C/strong%3E%3Cbr%3EBachelor%27s Degree Business, Finance, Accounting, Healthcare Administration, Data Analytics, or related field Req%3Cbr%3E%3Cbr%3E%3Cstrong%3EExperience%3C/strong%3E%3Cbr%3E3 Years Decision support, financial analysis, healthcare pricing, managed care analytics, or revenue cycle to include SQL or relational database experience and/or reimbursement methodologies. Req%3C/p%3E%3Cp%3EProficiency in Excel, Access and SQL, Experience with pricing and modeling platforms such as EPIC, PMMC, Tableau, Power BI, Power Query, Alteryx or other healthcare pricing and claim systems. Preferred%3C/p%3E%3Cp%3EFamiliarity with government and commercial payor reimbursement methodologies. Preferred%3C/p%3E%3Cp%3EKnowledge of hospital, ancillary, and physician coding systems. Preferred%3C/p%3E
%3Cp%3E%3Cstrong%3EEducation%3C/strong%3E%3Cbr%3EBachelor%27s Degree Business, Finance, Accounting, Healthcare Administration, Data Analytics, or related field Req%3Cbr%3E%3Cbr%3E%3Cstrong%3EExperience%3C/strong%3E%3Cbr%3E3 Years Decision support, financial analysis, healthcare pricing, managed care analytics, or revenue cycle to include SQL or relational database experience and/or reimbursement methodologies. Req%3C/p%3E%3Cp%3EProficiency in Excel, Access and SQL, Experience with pricing and modeling platforms such as EPIC, PMMC, Tableau, Power BI, Power Query, Alteryx or other healthcare pricing and claim systems. Preferred%3C/p%3E%3Cp%3EFamiliarity with government and commercial payor reimbursement methodologies. Preferred%3C/p%3E%3Cp%3EKnowledge of hospital, ancillary, and physician coding systems. Preferred%3Cbr%3E%3Cbr%3E%3Cbr%3E%3Cstrong%3ESkills%3C/strong%3E%3Cbr%3EProficiency in Excel, Access and SQL%3Cbr%3EExperience with pricing and modeling platforms such as EPIC, PMMC, Tableau, Power BI, Power Query, Alteryx, or other healthcare pricing and claim systems is a plus.%3Cbr%3EExcellent written and verbal communication and strong collaboration skills.%3Cbr%3EFamiliarity with government and commercial payor reimbursement methodologies.%3Cbr%3EKnowledge of hospital, ancillary, and physician coding systems.%3Cbr%3EStrong analytical and problem-solving skills, with ability to identify root causes of variance and interpret payor reimbursement methodologies.%3Cbr%3ECritical thinking skills, strong math and computer aptitudes, presentation skills.%3Cbr%3EAbility to manage multiple priorities in a fast-paced environment.%3Cbr%3E%3Cbr%3E%3Cstrong%3ESupervision%3C/strong%3E%3Cbr%3EIndividual Contributor%3Cbr%3E%3Cbr%3E%3Cstrong%3EADA Requirements%3C/strong%3E%3Cbr%3EExtreme Heat 1-33%%3Cbr%3EExtreme Cold 1-33%%3Cbr%3EExtreme Swings in Temperature 1-33%%3Cbr%3EExtreme Noise 1-33%%3Cbr%3EWorking Outdoors 1-33%%3Cbr%3EWorking Indoors 1-33%%3Cbr%3EMechanical Hazards 1-33%%3Cbr%3EElectrical Hazards 1-33%%3Cbr%3EExplosive Hazards 1-33%%3Cbr%3EFume/Odor Hazards 1-33%%3Cbr%3EDust/Mites Hazards 1-33%%3Cbr%3EChemical Hazards 1-33%%3Cbr%3EToxic Waste Hazards 1-33%%3Cbr%3ERadiation Hazards 1-33%%3Cbr%3EWet Hazards 1-33%%3Cbr%3EHeights 1-33%%3Cbr%3EOther Conditions 1-33%%3Cbr%3E%3Cbr%3E%3Cstrong%3EPhysical Demands%3C/strong%3E%3Cbr%3ESedentary%3Cbr%3E%26nbsp;%3C/p%3E
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