CommonSpirit Health

Payer Analytics Economics Analyst

CommonSpirit Health • $70K — $95K *
Englewood, CO 80112In-Person
Healthcare
Less than 5 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Bachelor's degree in Business Administration, Accounting, Finance, Healthcare, or related field
  • One year experience in financial healthcare reimbursement analysis
  • Understanding of national standards for fee-for-service and value-based reimbursement
  • Proficiency in financial analysis and data management strategies
  • Knowledge of managed care contracting and healthcare operations

Responsibilities

  • Perform pricing analysis for reimbursement negotiations between healthcare providers and payers
  • Monitor and analyze contract financial performance and profitability
  • Provide training on modeling payer contracts for stakeholders
  • Act as a liaison to communicate reimbursement changes with payers
  • Prepare reimbursement analyses to support financial performance evaluations
  • Identify and manipulate data from various financial and clinical databases

Benefits

  • Opportunities for professional development and training
  • Engaging work environment with a focus on data-driven decision making
  • Exposure to a variety of healthcare reimbursement strategies
  • Collaboration with cross-functional teams to enhance contract negotiations
Full Job Description
Job Summary and Responsibilities

As our Payer Analytics and Economics Analyst, you will be instrumental in leveraging data-driven insights to optimize our payer relationships, contract performance, and overall financial health.

Every day you will analyze payer contracts, claims data, and market trends to identify opportunities for revenue enhancement, cost reduction, and improved contract terms.

To be successful in this role, you must possess strong analytical, quantitative, and financial modeling skills, a comprehensive understanding of healthcare reimbursement methodologies, payer contracting, and managed care economics.
  • Perform strategic pricing analysis to support the negotiation and implementation of appropriate reimbursement rates and associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. Develop financial models and payer performance analysis.
  • Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability. Review and accurately interpret contract terms, including payer policies and procedures impacting contract performance.
  • Provide stakeholder training of the modeling of proposed/existing negotiated payer contracts, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes.
  • Act as a liaison between CommonSpirit Health and payer to update information and communicate changes related to reimbursement.
  • Prepare service line reimbursement analyses and financial performance analyses. Develop methods and models (involving multiple variables and assumptions) to identify the implications/ramifications/results of a wide variety of new/revised strategies, approaches, provision, parameters and rate structures aimed at establishing appropriate reimbursement levels.
  • Identify, collect, and manipulate from a wide variety of financial and clinical internal data bases (e.g. PIC, STAR, TSI, PCON, EPIC) and external sources. Identify and access appropriate data resources to support analyses and recommendations.


Job Requirements

Required
  • Bachelors Other in Business Administration, Accounting, Finance, Healthcare or related field and One (1) year of experience in financial healthcare reimbursement analysis is required, including an understanding of national standards for fee-for-service and value-based provider reimbursement methodologies,
  • Equivalent education and/or experience may be considered in lieu of degree.,
  • Experience in financial healthcare reimbursement analysis is required, including an understanding of national standards for fee-for-service and value-based provide reimbursement methodologie
  • Experience in contribution to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations

About CommonSpirit Health

CommonSpirit is a nonprofit health care center. They offer community health programs, research programs, virtual care services, and home health programs that address the root causes of poor health, such as access to care, affordable housing, neighborhoods, and a healthy environment.

CommonSpirit Health Careers

Join the dedicated team at CommonSpirit Health, a leader in healthcare innovation and community wellness. CommonSpirit Health offers a range of job opportunities that empower professionals to grow their careers in a supportive and diverse environment.

Explore Career Opportunities

CommonSpirit Health is actively hiring and offers a variety of positions that cater to different skills and career aspirations. From clinical roles to administrative positions, the company provides a platform for growth and professional development.

Experience a Culture of Care and Innovation

At CommonSpirit Health, the culture is grounded in diversity, leadership, and innovation. The team is committed to fostering an inclusive environment where every member’s contribution is valued. CommonSpirit Health leads with a spirit of compassion and a commitment to excellence in healthcare.

Join a Team That Values Diversity and Leadership

CommonSpirit Health believes in the power of diversity and leadership to drive innovation. The company invests in diversity training and leadership development programs, ensuring that all team members are equipped to lead with integrity and empathy.

Internship and Employment Opportunities

For those starting their career, CommonSpirit Health offers internship programs that provide hands-on experience in the healthcare industry. These internships are designed to develop essential skills and offer insights into various aspects of healthcare operations.

Benefits and Growth

Employees at CommonSpirit Health enjoy a comprehensive benefits package that supports both their professional and personal lives. The company is committed to the career growth of its employees, offering numerous opportunities for advancement and professional development.

Networking and Professional Development

CommonSpirit Health encourages networking and continuous learning. Employees have access to a wide range of professional development courses and are encouraged to connect with peers and leaders within the industry to enhance their career prospects.

Applying for a Position

To apply for a position at CommonSpirit Health, candidates should prepare their resume to highlight relevant experience and skills. The hiring process may include an interview to assess compatibility with the company’s values and culture. Interested candidates can explore job listings and submit applications through the CommonSpirit Health Careers portal.

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Explore CommonSpirit Health Careers

Discover the rewarding career opportunities at CommonSpirit Health. With a commitment to community health, innovation, and compassionate care, CommonSpirit Health is an ideal place to advance a career in healthcare. Search open positions that match skills and interests and join a team that’s making a difference.

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Learn more about CommonSpirit Health
Size
10,001 employees
Industry
Hospitals & Medical Centers
* Ladders Estimates

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