System Manager Payer Analytics Economics

Remote • Full-time

About the role

As our System Manager, Payer, you will provide strategic leadership and expert oversight for all aspects of our organization's payer relations and contracting, ensuring optimal financial performance and sustainable partnerships with health plans. You will manage a team responsible for negotiating, implementing, and monitoring contracts with various governmental and commercial payers across our system.

Responsibilities

• Manage the labor and operations of the Payer Analytics & Economics team including hiring, orienting, developing, and managing staff.
• Oversee quality control and quality assurance of Payer Analytics & Economics analytics deliverables and financial models to support negotiation and implementation of appropriate reimbursement rates and associated language between physicians/hospitals and payers/networks for managed care contracting initiatives.
• Review and accurately interpret contract terms, including payer policies and procedures, to appropriately contract performance and influence strategic pricing strategies.
• Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability.
• Provide training and oversight of the modeling of proposed/existing payer contracts, including expected and actual revenues/volumes, past performance, proposed contract language, and regulatory changes.
• Oversee and prepare complex service line reimbursement analyses and financial performance analyses. Develop methods and models (involving multiple variables and assumptions) to identify implications/ramifications/results of new/revised strategies, approaches, provisions, parameters, and rate structures.
• Prepare and effectively present results to senior leadership and other key stakeholders for review and decision-making activities.

Requirements

• Bachelor’s Degree in Business Administration, Accounting, Finance, Healthcare, or related field. Equivalent education and experience in related field(s) may be considered in lieu of degree.
• Five (5) years of experience contributing to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning, and/or healthcare operations.
• Two (2) years of experience in a supervisory role.

Pay

$110k - $130k / year