RCM Business Enablement Analyst

Accountabilities:

• • Build, test, maintain, and optimize insurance payer contracts and expected reimbursement rules to support accurate reimbursement calculations.
  • Apply healthcare, technical, analytical, and financial knowledge to ensure payer contracts are accurately implemented and effectively managed throughout their lifecycle.
  • Coordinate with Operations to validate and maintain reimbursement rules following initial development, quality assurance, and testing.
  • Maintain reimbursement model updates, including Medicare outpatient quarterly updates, annual DRG changes, and yearly increases for managed care contracts.
  • Perform comprehensive QA and testing by reviewing reports, outputs, and model results before publishing changes to production.
  • Partner with clients, managers, and team leads to research and resolve managed care contract questions and reimbursement-related issues.
  • Support Revenue Acceleration onboarding initiatives by identifying and validating data requirements, developing workflows and processes, providing training, and performing QA throughout implementation.
  • Analyze processes, systems, and data to identify gaps, improve efficiency, and recommend practical solutions.
  • Conduct ad hoc analyses and other projects as assigned by departmental leadership.
  • Maintain accurate documentation and contribute to continuous improvement across business enablement processes and tools.

  Requirements:

  • 1–3 years of relevant professional experience preferred, with 5+ years of healthcare industry experience required.
  • Background in healthcare revenue cycle management, billing, coding, or related areas strongly preferred.
  • Working knowledge of managed care contracting and reimbursement modeling is desirable.
  • Understanding of CMS reimbursement guidelines, including Medicare, IPPS, and OPPS logic.
  • Strong analytical thinking and the ability to evaluate data, workflows, and systems to identify issues and develop effective solutions.
  • Strong verbal and written communication skills, including the ability to explain complex information and facilitate training or presentations.
  • Demonstrated project management capabilities, including prioritization, organization, time management, implementation, and follow-through.
  • Familiarity with business enablement technologies such as CRM systems, learning management platforms, data analytics tools, and content management systems.
  • Strong collaboration skills and the ability to build productive relationships with clients, Operations leaders, and cross-functional teams.
  • High attention to detail and a consistent focus on accuracy, completeness, and quality.
  • Customer-centric mindset with the ability to understand end-user needs and develop solutions that improve productivity and experience.
  • Adaptability and willingness to learn new technologies, processes, and business requirements.
  • Ability to work independently as a self-starter while effectively collaborating with a broader team.
  • Comfortable working remotely for extended periods using a desktop or laptop, phone, keyboard, and mouse.

  Benefits:

  • Fully remote position within the United States, aligned with Central Time.
  • Full-time employment.
  • No travel required; travel expectation is 0%.
  • Opportunity to work at the intersection of healthcare, revenue cycle management, technology, analytics, and business enablement.
  • Collaborative environment with opportunities to work alongside healthcare operations and subject-matter specialists.
  • Exposure to payer contracting, reimbursement modeling, Medicare methodologies, and Revenue Acceleration initiatives.
  • Opportunity to contribute to process improvement, operational efficiency, and technology-enabled healthcare solutions.