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Manager Payer Analytics Economics id-25245

Responsibilities

This is remote position. Strong preference for candidate to live in Eastern or Central time zone. 

 

The Manager, Payer Analytics & Economics is accountable for the managed care financial analysis, strategic pricing and payer contract modeling activities for a defined payer portfolio. Oversees and provides analytical and pricing expertise for the evaluation, negotiation, implementation and maintenance of managed care contracts between CommonSpirit Health providers and payers. Recommends and acts on strategies for maximizing reimbursement and market share. Develops new managed care products with external payers that are consistent with CHI’s strategic plans. Provides education to key stakeholders. This position will serve and support all stakeholders through ongoing educational problem-solving support for managed care payer reimbursement models. This position requires daily contact with senior management, physicians, hospital staff, and managed care/payer strategy leaders. The position must handle adverse and politically difficult situations, as the work may have a direct impact on individual physician incomes, along with directly impacting the financial performance of CommonSpirit Health.

 

ESSENTIAL KEY JOB RESPONSIBILITIES

 


Qualifications

Required Education and Experience

 

  • 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.
  • Minimum of five (5) years of experience in Healthcare Finance contributing to profitability through detailed financial analysis of managed care contracts is required. Experience in trend management, budgeting, forecasting, strategic planning, and/or healthcare operations is preferred.
  • Minimum of two (2) years of experience in a lead or supervisory role. 

 

Required Minimum Skills, Abilities & Training

  • Strong background in financial healthcare reimbursement analysis is required, including an understanding of national standards for fee-for-service and value-based provider reimbursement methodologies.
  • High level of technical understanding and proficiency in MS Excel, or other related database applications.
  • Intermediate level working knowledge of SQL.
  • Must be able to lead and coordinate analysis projects through various complex and challenging situations to completion under time-sensitive deadlines.
  • Must have working knowledge of healthcare financial statements and accounting principles.
  • Ability to use and create data reports from health information systems, databases, or national payer websites (EPIC, PIC, SQL, Databases, etc.).
  • Proficiency in reading, interpreting and formulating computer and mathematical rules/formulas.
  • Ability to effectively lead teams through influence.
  • Ability to effectively build and sustain collaborative relationships with all levels of the organization.

Overview

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2300 clinics care sites and 137 hospital-based locations in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157000 employees 45000 nurses and 25000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care community benefits and unreimbursed government programs. Together with our patients physicians partners and communities we are creating a more just equitable and innovative healthcare delivery system.

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