Managed Care Contract Analyst I

Develops financial models to support payer contract negotiations and optimize payer performance and reimbursement outcomes. Analyzes financial and reimbursement data and delivers payer contract performance reporting that informs decision-making for leadership, committees, and stakeholders.

Responsibilities

• Designs and builds simple financial models to support various reporting and contracting needs.
• Works with other departments within the organization and leverages internal reporting systems to gather and compile the required data.
• Employs basic understanding of Hospital/physician contractual reimbursement methodologies.
• Prepares appropriate analyses for review by various committees and senior leadership.
• Prepares monthly, quarterly, and yearly payer contract performance reports and presents performance trends at the department all-staff meeting.
• Prepares and distributes monthly reports for financial close processes, consistently following established procedures for formatting and accuracy.
• Maintains and updates the Managed Contract System based on commercial and governmental contracts. Performs system set-up and testing as necessary to ensure contracts are accurately configured and modeled.
• Compiles quarterly and annual Hospital/physician fee schedules as required by payer contracts. Distributes fee schedules to internal and external clients as needed.
• Maintains organized and well-documented project files.
• Researches and analyzes financial data for internal and external clients.
• Creates, organizes, and maintains files using database and spreadsheet programs; retrieves and organizes data into required reporting formats.
• Develops, prepares, and presents a variety of ad-hoc reporting, financial models, and analyses as requested.
• Provides functional support to Analyst II and Senior Analyst for various projects as needed. Leverages Analyst II and Senior Analyst for shared knowledge and expertise.
• Provides constructive feedback to colleagues in a timely manner to improve output.
• Performs other tasks as assigned.
• Staffs finance-related Committees, as required.

Requirements

• Analytical and problem-solving skills: collect information from multiple sources, check information for reasonability, and identify conflicting information.
• A willingness and ability to learn about healthcare data sets and data systems, financial reporting processes, and external market dynamics.
• Organization and documentation of variables, assumptions, and data sources.
• Ability to follow standardized processes accurately and consistently.
• Familiarity with MS Office applications, particularly Excel. Technical skills to execute common Excel formulas (sum, if, Vlookup, pivot tables).
• Ability to communicate effectively both orally and in writing and provide empathy in difficult interpersonal situations.

Qualifications

• Bachelor’s Degree required.
• Area of study: Business/Finance or a closely related field required.

Pay

The posted pay range is Boston Children’s reasonable and good-faith expectation for this pay at the time of posting. Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors.

Benefits

• Flexible schedules.
• Affordable health, vision, and dental insurance.
• Child care and student loan subsidies.
• Generous levels of time off.
• 403(b) Retirement Savings plan.
• Pension.
• Tuition and certain License and Certification Reimbursement.
• Cell phone plan discounts.
• Discounted rates on T-passes.