Senior Manager, Managed Care Analytics - Full Time - Days - Corporate

About the role

The Senior Manager of Managed Care Analytics serves as the enterprise leader for payer analytics, reimbursement modeling, and data governance across the managed care contracting lifecycle. This role is the system’s chief data steward for managed care, responsible for ensuring analytical accuracy, methodological consistency, and strategic insight that directly shapes payer negotiations, revenue integrity, and long-term financial performance. This leader oversees a team of analysts and collaborates closely with Managed Care, Finance, Revenue Cycle, Population Health, Clinical Operations, and executive leadership.

Responsibilities

• Serve as the Managed Care department’s data steward, ensuring data accuracy
• Partner with IT, Finance, Revenue Cycle, and Informatics to align data sources, methodologies, and reporting infrastructure
• Drive the development of advanced financial models, contract repricing engines, payer scorecards, and market intelligence tools that support both fee-for-service and value-based arrangements
• Analyze historical and projected payer performance, including medical cost trends, utilization patterns, yield changes, and reimbursement impacts
• Forecast financial risks and opportunities associated with managed care contracts
• Lead financial modeling and repricing analyses to support payer contract negotiations across hospital, physician, ancillary, and value-based arrangements
• Use Epic tools to model contract changes, forecast reimbursement impacts, and support negotiation strategy
• Collaborate with the Director of Managed Care to prioritize and assign analytical work, review outputs, and ensure adherence to data governance standards
• Foster a collaborative, high-performance analytical environment
• Act as a key analytical partner to Finance, Revenue Cycle, ACO/Population Health, Clinical Operations, and other stakeholders
• Participate in interdisciplinary workgroups and system-wide initiatives requiring payer analytics or reimbursement expertise
• Clearly convey complex analytical insights to leadership and diverse stakeholder groups
• Lead payer proposal evaluation, counter proposal development, and negotiation analytics
• Develop dashboards and scorecards that track payer performance, yield, denial trends, PMPM, MLR, TME, and value-based metrics
• Build payer specific P&Ls and profitability analyses
• Maintain market intelligence tools, including competitor profiling and regional market assessments
• Monitor medical cost trends, utilization patterns, and reimbursement shifts
• Drive automation of recurring analytics, including SQL pipelines, BI dashboards, and contract modeling workflows

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Public Health, Mathematics, Informatics, Computer Science, or related field
• Master’s degree (MBA, MHA, MPH, Informatics) preferred
• Experience 5–8 years of experience in medical cost analytics, managed care analytics, actuarial analysis, or related healthcare data roles preferred
• Experience leading analytical projects or teams; project management experience preferred
• Strong understanding of managed care reimbursement methodologies and medical economics metrics (PMPM, MLR, TME, etc.)
• Experience working with healthcare claims, encounter data, and financial modeling
• Proficiency in SQL, Excel (advanced modeling, macros/VBA), and BI tools such as Power BI, Tableau, or Spotfire
• Epic Resolute Hospital Billing and/or Professional Billing Contract Administration preferred; required within 9 months if not already certified

Benefits

Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:

• Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
• Life & AD&D Insurance
• Short-Term and Long-Term Disability (with options to supplement)
• 403(b) Retirement Plan: Employer match, additional non-elective contribution
• PTO & Paid Sick Leave
• Tuition Assistance, Advancement & Academic Advising
• Parental, Adoption, Surrogacy Leave
• Backup and On-Site Childcare
• Well-Being Rewards
• Employee Assistance Program (EAP)
• Flexible Spending & Commuter Accounts
• Pet, Home & Auto, Identity Theft and Legal Insurance

Pay

Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.

Schedule

Details on the schedule will be provided at the time of offer.