Senior Payer Contract Analyst (Full-Time/Day) Hybrid

Hybrid role requiring quarterly travel to the location.

About the role

Perform scenario modeling and analytics to inform managed-care contract negotiations, monitor contract performance, and assess the impact of industry trends and government regulations. Retrieve, aggregate, and analyze data from multiple sources using a variety of tools to support the Payer Contracting department. Collaborate with team members to understand their needs and goals, functioning as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.

Responsibilities

• Conduct detailed managed-care contract modeling and analysis using available contract modeling systems.
• Build flexible models that aggregate fee-for-service and value-based data from multiple sources and enable scenario play.
• Maintain key department metrics (e.g., Managed Care Financial Reporting package, payer mix, reimbursement benchmarks) and monitoring tools (e.g., contract and rate tracking grids).
• Ensure compliance with all CMS Price Transparency requirements relating to development, accuracy, and publication of machine-readable files.
• Monitor payer policy updates and quantify impact of potential material harm and/or other contract implications.
• Validate payer rate loads to ensure contracts are executed accurately and perform root-cause analysis of variances.
• Serve as a resource to management to assist in ad-hoc projects.

Requirements

• Bachelor’s degree in Finance, Healthcare Administration, Business, or a related field.
• 5+ years of experience in payer-related positions within the provider or insurance industry, with a minimum of 5 years in budgeting, insurance/payer-related financial analysis, net revenue reimbursement modeling, performance computations, decision support, and general financial reporting.
• Intermediate to advanced capabilities with Microsoft Excel and PowerPoint.
• Experience building and manipulating Contract Modeling tools and BI/Data Analytics applications (e.g., Qlik, Tableau, Microsoft Power BI, EPSi).
• Ability to thrive in a fast-paced, agile work environment with high expectations and accountability.
• Excellent written and verbal communication skills.
• Strong conceptualization, analytical, and logic skills.

Preferred Qualifications

• Master’s degree in Finance, Healthcare Administration, Business, or a related field.

Physical Demands

• Lift and carry up to 25 lbs.
• Frequent sitting/standing and keyboard use.

Schedule

Monday - Friday, 8:00 am - 4:30 pm.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including:

• Medical (including prescription), supplemental insurance, dental, and vision coverage.
• Life and AD&D insurance.
• Short- and long-term disability.
• Flexible spending accounts.
• Retirement plans.
• Tuition assistance and access to tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service.
• Voluntary benefits, providing access to group rates on insurance and discounts.

All colleagues, including those who work less than part-time (e.g., per diem, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.