Managed Care Analyst

Key Responsibilities

• Develop, distribute, and support recurring and ad hoc financial and operational reports related to Beacon Managed Care, ACOs, MSSP performance, and value-based initiatives.
• Partner with business users to interpret financial results, performance trends, benchmarks, and assumptions.
• Produce scenario-based financial analyses and recommendations supporting strategic planning and decision-making.
• Support financial evaluations of proposed contracts, payer arrangements, and programs by interpreting contractual language and modeling financial impact.
• Contribute to the development of a data-informed culture by presenting insights, identifying risks and opportunities, and proposing data-driven solutions.
• Document all deliverables, including methodologies, assumptions, data sources, and user requirements to ensure repeatability, transparency, and audit readiness.
• Participate with cross-functional teams on projects such as payor data feeds (incoming and outgoing), Oracle HDI set up and file transfers related to managed care and ACO.
• Meet deadlines by prioritizing reoccurring reporting requirements and ad-hoc report requests.

MSSP Compliance Responsibilities

• Serve as a key analytical and operational support resource to ensure Beacon’s ongoing compliance with CMS Medicare Shared Savings Program (MSSP) requirements.
• Support monitoring and reporting of MSSP financial performance, benchmarks, expenditures, and shared savings calculations in alignment with CMS guidance.
• Aid in preparing and validating data, reports, and documentation required for CMS submissions, audits, and reconciliations related to ACO participation.
• Ensure analytical methodologies, assumptions, and reporting outputs align with MSSP regulations, program rules, and contractual ACO obligations.
• Partner with Managed Care, Finance, Compliance, Quality, and Value based Health teams to identify compliance risks, data discrepancies, and performance trends impacting MSSP outcomes.
• Escalate potential compliance concerns, data integrity issues, or regulatory changes impacting MSSP participation to leadership as appropriate.

Qualifications

• The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a bachelor’s degree in finance, Business, Analytics, Healthcare Administration, or a related field.
• Minimum of 2 years' professional experience creating financial analysis, contract performance analysis, reports and dashboards, and data driven recommendations, preferably in a healthcare setting.
• Requires strong analytical, organizational, and communication skills to collect, analyze, and deliver accurate, time sensitive insights in a fast paced healthcare environment.
• Demonstrates proficiency in financial and managed care concepts, value based reimbursement models, and tools such as Excel and PowerPoint.
• Capable of working independently in ambiguous situations, prioritizing multiple initiatives, leading data driven projects, and collaborating effectively across all levels and departments of the health system.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.