Job Summary
Provides data retrieval / contract modeling / financial analysis support to Director, VP, and Managed Care Regional Contracting Directors.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Retrieves reimbursement data from hospital and physician accounting systems.
- Builds financial models to analyze and evaluate the reimbursement impact of hospital and physician payer reimbursement methodology proposals
- Works with Managed Care Regional Contracting Directors on contract interpretation issues to ensure accuracy of contract models and financial analysis.
- Produces clear and concise written reports summarizing payment modeling analysis.
- QA monthly data loads.
- Completes special projects/reports as needed
Qualifications:
- Well versed in reimbursement methodology including DRG, APC, COPPS, OPPS, Case Rates, Per Diems, HCPCS and CPT Code Fee Schedules (2-5 years’ experience).
- Familiar with hospital and physician billing and coding terminology including diagnostic codes, revenue codes, procedure codes, and HCPCS codes.
- Well versed in healthcare product lines including HMO, PPO, HIX, Medicare, Medicaid, Tricare, Workers Comp.
- Must be able to clearly communicate complex and technical issues in writing and verbally.
- Must have the ability to work independently and manage multiple projects simultaneously
Computer Skills:
To perform this job successfully, an individual should have knowledge of
- Word Processing software
- Exceptional skills in Excel.
- Knowledge of contract modeling systems such as FinThrive preferred.
- Knowledge of Access or SQL preferred.
Education/Experience:
- Bachelor’s degree required; emphasis in Accounting or Data Analytics preferred
- 2-5 years’ work experience required
- Prior experience in hospital, physician or health plan financial analysis, or equivalent experience preferred
- Knows/has modeled/worked with health plan/hospital and physician managed care commercial and Medicare reimbursement methodologies and terminology
Skills Required
- Bachelor’s degree
- 2-5 years of work experience
- Knowledge of reimbursement methodologies including DRG, APC, COPPS, OPPS, case rates, per diems, HCPCS, and CPT fee schedules
- Familiarity with hospital and physician billing and coding terminology, including diagnostic, revenue, procedure, and HCPCS codes
- Knowledge of healthcare product lines including HMO, PPO, HIX, Medicare, Medicaid, Tricare, and Workers’ Compensation
- Ability to communicate complex and technical issues clearly in writing and verbally
- Ability to work independently and manage multiple projects simultaneously
- Exceptional Excel skills
- Prior hospital, physician, or health plan financial analysis experience, or equivalent experience
- Accounting or Data Analytics emphasis
- Knowledge of contract modeling systems such as FinThrive
- Knowledge of Microsoft Access or SQL
Community Health Systems Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Community Health Systems and has not been reviewed or approved by Community Health Systems.
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Healthcare Strength — Stated offerings include medical, dental, vision, and prescription coverage, alongside life and disability insurance. Coverage breadth is presented as a core part of the package across affiliated hospitals.
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Leave & Time Off Breadth — Paid time off for vacation, holidays, and illness is part of the package. Time-away benefits are included as a standard element across roles and facilities, subject to local terms.
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Wellbeing & Lifestyle Benefits — Tuition assistance, student-loan support, and license or certification reimbursement are emphasized, particularly for clinical roles. These programs can reduce education costs and support ongoing professional development.
Community Health Systems Insights
What We Do
Community Health Systems, Inc. is one of the nation’s leading operators of general acute care hospitals. The organization’s affiliates own, operate or lease more than 80 hospitals in 16 states with approximately 15,000 licensed beds. Affiliated hospitals are dedicated to providing quality healthcare for local residents and contribute to the economic development of their communities. Based on the unique needs of each community served, these hospitals offer a wide range of diagnostic, medical and surgical services in inpatient and outpatient settings.
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