Provides analytical support for payor contracting for all health system entities. Works collaboratively with other analysts and health system leaders to provide optimal support across the organization.
Essential Job Duties:
- Analysis - Performs thorough and accurate quantitative analysis of payor rates, using industry benchmarks, trends, rate proposals, annual rate inflators, value-based performance incentives, and other factors to determine the financial impact, estimate budget projections, and to create clear and intuitive reports and presentations. Interprets and summarizes data and makes recommendations for improvement to stakeholders in an organized and concise manner.
- Inventory - Maintains contract inventory, including current and historical rates by code, key language, volume/revenue, payor mix, and negotiation timelines by entity and payor. Develops familiarity with contract language, rate and payment methodologies, payor policies, and coding to support contract negotiations and other health system needs.
- Reports - Runs and analyzes volume and revenue reports, and produces periodical payor mix and payor performance reports, and other reports as needed. Assists with the creation of SOP for reports needed for the department.
- Support - Provides payor contract-related service support for business leaders and strategic initiatives that impact patient care delivery and the financial well-being of the health system. Responds to internal and external requests for information and special projects. Provides useful payor contract-related information to leaders and others upon request and proactively. Primary responsibility for the creation and internal distribution of rate sheets.
- Relationships - Builds and maintains good relationships with payor representatives and internal organizational stakeholders in order to obtain timely information, respond to inquiries, and troubleshoot problems. Obtains rates and rate methodologies directly from the payors.
Required Minimum Education:
Bachelor's Degree from an accredited college or university in the fields Finance, Health Care Administration or Business. If currently attending college in pursuit of a degree in one of these fields, must at least be in third year of study.
Required Minimum Experience: Six years of related work experience at the analyst level, including hospital and physician practice contract-related work. Work experience at payor or with payors strongly preferred. Strong knowledge of computer software programs. Ability to manage multiple projects and large volumes of data and prioritize work under minimal supervision. Excellent verbal and written communication skills. High level of interpersonal skills. Ability to judge the level of confidentiality and relevance of information/activities involved in and exhibit integrity in use or dissemination of such information. Ability to work in a stressful and demanding environment.