Director – Payer Strategy & Contracting Analytics
Hospital for Special Surgery · New York, NY · 6 mo ago
Analyst$129k–$196k/yrFull-time
Responsibilities
- Work closely with the Contracting team to provide analytical support for all contracting efforts, including payer contracting, bundled payment contracting, pay-for-performance contracting, and other emerging reimbursement methodologies.
- Create and maintain models and data products to evaluate the financial success and impact of new contracts, opportunities, and policy changes, building automated processes that can be reused and scaled across multiple contracts and scenarios.
- Partner with the Payer Strategy & Contracting team to drive automation – design and manage automated reporting solutions, transitioning existing manual processes into scalable, repeatable workflows within the enterprise data lakehouse.
- Collaborate across the Data & Analytics team to align payer strategy data needs with the broader enterprise data strategy.
- Serve as a subject matter expert in payer strategy analytics, acting as the primary liaison between the Payer Strategy & Contracting team and the Data & Analytics organization.
- Mentor junior analysts, building technical and analytical capabilities while fostering knowledge of payer strategy and contracting.
Qualifications
- Bachelor's degree in Data Science, Finance, Economics, Health Administration, or related field (Master's preferred).
- 7+ years provider/payer contracting experience.
- Strong understanding of payer contracting concepts, reimbursement methodologies, and healthcare financial drivers.
- Advanced experience with APR-DRG, MS-DRG, Ambulatory Surgery Center groupers, APC, APG, and RBRVS reimbursement methodologies.
- Proficiency in SQL and experience working with enterprise data platforms.
- Demonstrated ability to automate reporting and analytic workflows.
- Knowledge of hospital operations, health/insurance benefit plans, revenue cycle claims systems and complex reimbursement methodologies.
- Proven track record of developing models to evaluate financial impact of contracts, policy changes, or new opportunities.
- Strong communication skills with the ability to translate complex analytics into clear, actionable insights for non-technical stakeholders.
- Experience mentoring or managing analysts, with a focus on developing both technical and business acumen.
- Comfort working cross-functionally – particularly with finance, contracting, and technical data teams.