Job DescriptionThe Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts on: Facility related Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of implementing Facility and Ancillary Contracts across the Mount Sinai Health System.
MSHP seeks a
Senior Contracting Analyst to analyze and report the financial performance for all Commercial and Medicare Contracts with Mount Sinai. The Senior Contracting Analyst has responsibilities that include: analyzing medical and pharmacy trends, researching all facility amendments, procuring all financial data necessary for driving Mount Sinai's Facility models, and reconciling financial data. The Senior Contracting analyst is also expected to liaise and coordinate with other departments in Mount Sinai Health Partners.
Responsibilities- Research from the original contract amendments all financial terms.
- Procure and upload all financial data into Experian Contract Manager Tool to determine financial performance.
- Model Payer Proposals in Experian Contract Manager Tool.
- Reconcile budgeted revenue vs actual revenue collected.
- Perform Root Cause Analysis on medical and pharmacy trends for all contracts.
- Create Power Point Presentations detailing any analysis regarding facility contracting performance.
- Collaborate and liaise with other departments such as Commercialization, Finance, and Patient Accounts.
- Responsible for overall management and delivery of the business plan. Financial analysis and creation of reports as requested by department administrator or chairman as applicable
- Compiles productivity, compliance and profit/loss reports
- Analyzes revenues to identify collection problems, billing issues and other trends.
- May be well versed and take a proactive role in the revenue cycle, which includes all administrative and clinical functions that contribute to the capture, management and collection of patient service revenue, including overseeing those who may counsel patients on how best to meet their financial obligations.
- Reviews processes and makes recommendations to implement effective changes in procedures and policies.
- Assists with or leads special projects and provides analytical support.
- Performs other related duties.
QualificationsEducation Requirements • HS/GED; Bachelors strongly preferred. Additional experience needed in addition to "experience requirements" listed below in lieu of education.
Experience Requirements • At least seven years of experience in healthcare analytics required (with a Bachelors degree).
• Health plan experience in Medical Economics or Value Based Payments preferred.
Additional Skills and Qualities• Understanding of Excel functions such as VLOOKUP, Pivot Tables, and SUMIFS required.
• Basic understanding of statistical concepts such as per capita, weighted averages, variances, and forecasting required.
• Experience analyzing Facility, Professional and Pharmacy cost trends preferred.
• Familiarity with amendments between payers and providers preferred.
• Firm understanding of Facility, Professional and Pharmacy claim reimbursement preferred.
• Oral presentation experience, especially with senior management, preferred.
• Understanding of data and financial reconciliation preferred.
Compensation StatementThe Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $96,461.00 - $144,692.00 Annually. Actual salaries depend on a variety of factors, including experience, education, and operational need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.
Non-Bargaining Unit, E01 - Partner MSO Services - MSH, Mount Sinai Hospital
