Job Details
Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.
Job Description
Schedule: Monday - Friday, 8:00 am - 4:30 pm.
Hybrid: Travel to the location quarterly
Summary
Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.
Job Duties
- Conduct detailed managed care contract modeling and analysis using available contract modeling systems.
- Build flexible models that aggregate fee-for-service and value-based data from multiple sources and enable scenario play.
- Maintain key department metrics (e.g. Managed Care Financial Reporting package, payer mix, reimbursement benchmarks) and monitoring tools (e.g.contract and rate tracking grids).
- Ensures compliance with all CMS Price Transparency requirements relating to development, accuracy, and publication of machine-readable files.
- Monitor payer policy updates and quantify impact of potential material harm and/or other contract implications.
- Validate payer rate loads to ensure contracts are being executed accurately and perform root-cause analysis of variances.
- Serves as a resource to management to assist in ad-hoc projects.
Minimum Qualifications
- Bachelor’s Degree Finance, Healthcare Administration, Business or related field
- 5 years Experience in payer related position(s) in provider or insurance industry with minimum 5 years experience in budgeting, insurance/payer related financial analysis, net revenue reimbursement modeling and performance computations, decision support, and general financial reporting.
- Intermediate to advanced capabilities with Microsoft Excel and PowerPoint
- Experience building and manipulating Contract Modeling tools and BI/Data Analytics applications (e.g. Qlik, Tableau, Microsoft PowerBI, EPSi).
- Ability to thrive in a fast-paced, agile work environment with high expectations and accountability.
- Excellent written and verbal communication skills.
- Efficient conceptualization, analytical and logic skills.
Preferred Qualifications
- Master’s Degree Finance, Healthcare Administration, Business or related field
Additional Qualifications
Physical Demands
Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Thomas Jefferson University Hospitals, Inc.
Primary Location Address
1101 Market, Philadelphia, Pennsylvania, United States of America
