Senior Contract Analyst - REMOTE
Job Summary
Under the strategic direction of the Manager of Payer Analytics, the Senior Analyst of Payer Analytics will drive payer contracting strategy by performing in-depth contract analytic design, execution, and interpretation. This involves deep dive analytics into payer performance and proposed contract terms to order to make decisions on how to structure payer contracts. This position will participate in the design and interpretation of standard reporting as well as conducting ad-hoc drilldowns for specific business issues. There will be interaction with CEOs and executives across three hospital sites as well as revenue cycle, payer relations, and other leadership teams.
Job Responsibilities
Strategy and Insights: Work with payer relations team on analytic design, execution, and interpretation. Deliver and present analytics and interpretation to business leaders in a digestible format. Provide perspective on new analytics to support payer reimbursement and performance. Proactively take steps towards automation or use of new technology. Provide thoughtful perspective in meetings with management. Understand Medicare and commercial reimbursement, policies, and regulatory requirements and apply to contract modeling, insights, and new ideas. Manage customer expectations and relationships and maintain alignment of deliverables with organization analytic needs. Serve as an expert on payer contract financial terms and financial modeling. Design and interpret analytics, lead training, and respond to questions across multiple departments.
Contract Maintenance: Load, update, and maintain contracts in collaboration with a vendor. Develop and maintain workflows and management processes to ensure there are no errors in contract modeling or loading. Model the effect of fee schedule updates on revenue and percentage of Medicare. Identify, interpret, and make recommendations regarding unclear contract or proposed contract terms.
Analytic Support: For both payer contract negotiations and monitoring, discuss business needs with customer and influence the design of an analysis and execute based on jointly designed specifications. Analyze data to work with colleagues to generate business insights and roll up data into a digestible format. Ability to use data extract and BI tools such as SQL and Tableau/PowerBI. Work with manager to efficiently merge data from multiple databases and find efficient ways to complete reporting.
Skills, Education and Additional Information
Minimum of bachelor’s degree in Business, Healthcare, Computer Science or related field. Master’s degree in Business Administration or comparable field of study preferred.
3 or more years’ experience in a managed care/healthcare environment with exposure to contract management and program development
EPIC experience
EPIC Hospital and Professional contract certification
Technical ability in ETL and visualization tools such as Tableau, PowerBI, and SQL
Knowledge of claims processing systems and guidelines
Experience with reimbursement methodologies for Medicare and commercial insurance; and regulatory requirements concerning payer contracts
Ability to produce analytics that are well-documented and easy to follow
Analytical skills with the ability to collect, organize, analyze, and disseminate information with attention to detail and accuracy
Strong written and verbal presentation skills including the ability to translate information to a variety of audiences
Ability to build strong relationships with internal and external stakeholders
Ability to be flexible and adapt in order to achieve initiative and organizational goals
Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.
Core Accountabilities
Organizational Impact: Independently delivers on objectives with understanding of how they impact the results of own area/team and other related teams.
Problem Solving/ Complexity of work: Utilizes multiple sources of data to analyze and resolve complex problems; may take a new perspective on existing solution.
Breadth of Knowledge: Has advanced knowledge within a professional area and basic knowledge across related areas.
Team Interaction: Acts as a "go-to" resource for colleagues with less experience; may lead small project teams.
Position Qualifications
Responsibilities:
Certifications:
Work Experience:
Relevant Work Experience:
Experience Level:
Education: