Epic Contract Analyst (Assistant Director of Fiscal Affairs), Managed Care Administration - NYC Health

NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city’s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Job Description

The Assistant Director-Epic Contract Analyst will be primarily responsible for communicating to key stakeholders the negotiated technical and professional rates in managed care contracts. The Assistant Director will also be responsible for maintaining an inventory of negotiated rates and fee schedules to support processes that ensure rates and billing terms are constructed and implemented correctly in respective billing system(s).

Working under the direct supervision of the Director of Fiscal Affairs, the key responsibilities of the Epic Contract Analyst position include and are not limited to:

• Review rate exhibits in managed care contracts and collaborate with colleagues in Revenue Cycle Services and Managed Care Operations to validate that services, revenue/CPT codes, and reimbursement methodology align with CMS Medicare and NYS Medicaid billing and payment procedures. 
• Create detailed rate transmittal(s) by translating rates outlined in executed managed care contracts to Epic contract terminology.  
• Monitor progress of rate transmittal(s) in the ServiceNow ticketing system and departmental tracker.  
• Disseminate rate transmittal(s) and associated fee schedule(s) to key stakeholders for contract creation for all service lines in Epic, Point Click Care, and other financial systems, if applicable.
• Assist with the building of expected reimbursement rates in Epic, as applicable.
• Collaborate with the key stakeholders to validate and ensure negotiated contract rates and billing terms are constructed and implemented correctly and timely in Epic and other financial systems. Maintain inventory of payer specific fee schedules and upcoming trend increases to timely produce a rate transmittal with updated rates. 
• Assist Managed Care colleagues, EITS Epic Hospital Billing Support team, and Revenue Cycle Services in the review of hospital contract variance inquiries, which includes accounts underpaid, denied, and other revenue-generating projects. 
• Support the Managed Care Contracting team in rate modeling analyses and ongoing rate negotiations. 
• Performs other related duties, as directed.

Minimum Qualifications

1. Master’s degree from an accredited college or university in Accounting, Finance, Business Administration or a related discipline with an emphasis on accounting and financial systems; and two (2) years of responsible-level experience in fiscal management or administration with an emphasis on financial systems, management information and controls, one (1) year of which must have been in a responsible administrative or managerial capacity; or
2. Bachelor’s degree from an accredited college or university in disciplines, as listed in “1” above; and three (3) years of experience, as described in “1” above, one (1) year of which must have been in a responsible administrative or managerial capacity.

Department Preferences

• Four (4) years of satisfactory, full-time paid experience in a corporation, consulting firm, governmental agency or foundation in management analysis or in operational direction, planning, coordination or control of which two (2) years must have been in a supervisory, administrative or consultative capacity; or 
• Five (5) years of experience as stated in #1 above, of which three (3) years must have been in a supervisory, administrative or consultative capacity; or  A satisfactory equivalent, however, all candidates must possess not less than the two (2) years of supervisory, administrative or consultative experience required; 
• Four (4) years of appropriate general experience may be substituted for a Baccalaureate degree requirement.  Appropriate full-time teaching experience in an accredited college or university may be substituted on a year-for-year basis for the required general experience and appropriate full-time teaching experience in a position of professional rank may be substituted on a year-for year basis for the required supervisory, administrative or consultative experience. 
• Healthcare reimbursement experience is required
• Experience with Epic Financials-specifically Hospital Billing (HB)
• CMS Medicare and New York Medicaid billing guidelines are strongly preferred 
• Candidate must have experience in government reimbursement methodologies and billing.  
• Epic Resolute Hospital Billing Expected Reimbursement Contracts certification is preferred. 
•  Candidate must be able to maintain organized work, effectively prioritize workload, and track different elements of processes.  

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Loan Forgiveness Programs for eligible employees
• Paid Holidays and Vacation in accordance with employees Collectively bargained contracts
• College tuition discounts and professional development opportunities
• Multiple employee discounts programs