Managed Care Analyst

The Managed Care Analyst position is responsible for building, maintaining, optimizing, and analyzing managed care contracts within Epic's Contract Maintenance and Contract Modeling modules for both hospital (HB) and professional (PB) billing environments to ensure accurate reimbursement calculations. This position requires technical expertise in Epic, deep understanding of healthcare financial workflows, and strong analytical skills to ensure contract integrity, accurate reimbursement modeling, and strategic decision support.

The Analyst serves as a bridge between technical teams, finance, managed care administrators, and operational teams to translate complex contractual and technical information into actionable business insights, with a focus on advanced data analysis and accurate calculation automation.

The Managed Care Contract Analyst is an essential part of MD Anderson Cancer Center. MD Anderson Cancer Center is a leading institution focused on cancer care, research, education, and prevention. This role helps ensure data-driven decisions that support clinical, operational, and strategic initiatives across the institution.

The ideal candidate will have experience building, maintaining, and managing managed care contracts in Epic, including hands-on experience with Epic contract modeling.

The typical work schedule is Monday - Friday 8am - 5pm.

Work Location: Remote (Must be able to attend meetings onsite).

Why Us?

In this role, you contribute to the mission of MD Anderson by providing the analytical insight needed to guide operational and clinical decisions, supporting both institutional effectiveness and patient focused outcomes.

• Employer-paid medical coverage starting day one for employees working 30+ hours/week, plus optional group dental, vision, life, AD&D, and disability insurance.
• Accruals for PTO and Extended Illness Bank, plus paid holidays, wellness, childcare, and other leave options.
• Tuition Assistance Program after six months of service and access to extensive wellness, fitness, and employee resource groups.
• Defined-benefit pension through the Teachers Retirement System, voluntary retirement plans, and employer-paid life and reduced salary protection programs.

Responsibilities

• Epic Contract Management (30%) o Build, test, implement, and maintain complex contracts within Epic Contract Maintenance to support accurate expected reimbursement calculations across all payer systems.
• o Develop and configure advanced HB and PB contract rules, components, and extensions to ensure precise payment modeling across multiple service lines.
• o Perform Epic system build and maintenance within Hyperdrive, Text, PJX/SUP, REL, and Data Courier environments.
• o Participate in Epic system upgrades, testing, and enhancement activities to maintain system performance and functionality.
• o Maintain Epic certification(s) and actively pursue continuous improvement of technical and analytical proficiency.
• o Proficient in data analytic tools including, Epic Reporting, SAP BI, Microsoft Excel, including complex formulas, tools, and design.
• Analysis & Data Management (35%) o Produce high-quality, accurate qualitative and quantitative analyses to support revenue cycle, financial performance, reimbursement, and managed care contract functions.
• o Conduct in-depth analyses of contract performance, payer trends, denials, and regulatory impacts to identify root causes and improvement opportunities.
• o Ensure all analytical deliverables provide meaningful interpretation, clear presentation, and actionable insights.
• o Design and develop innovative reports, dashboards, and data visualizations using tools such as Epic, Business Objects (Webi/SAP Universes), StrataJazz, Power BI, and Excel.
• o Develop scalable, self-service reporting solutions that empower stakeholders to make data-driven decisions.
• Epic Contract Modeling (25%) o Interpret managed care contract and policy language to accurately model and operationalize payment terms within Epic.
• o Evaluate payer reimbursement methodologies (CPT, HCPCS, MSDRG, APC, ICD-10, etc.) and assess related financial impacts.
• o Monitor and analyze managed care contract performance for compliance, accuracy, and reimbursement optimization.
• o Maintain up-to-date knowledge of third-party reimbursement regulations, including Medicare, Medicaid, Medicare Advantage, and commercial payers.
• o Identify and communicate revenue opportunities, risk areas, and cost-saving initiatives based on contract performance analyses.
• Customer Service & Collaboration (10%) o Engage with internal customers through regular meetings, clear documentation of requirements, and timely delivery of results.
• o Communicate technical and analytical findings in a clear, concise manner tailored to non-technical audiences and leadership.
• o Collaborate effectively with Patient Access, Financial Services, Managed Care, Information Technology, and Revenue Cycle teams to support organizational goals.
• o Maintain open, proactive, and professional communication channels with all stakeholders before, during, and after project deliverables.