CommonSpirit Health

System Manager Payer Analytics Economics

CommonSpirit Health$110K — $130K *
US-AnywhereRemote in Rancho Cordova, CA
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or related fields, or equivalent experience
  • Five years in detailed financial analysis and data management for contract analysis
  • Two years in a supervisory role
  • Strong analytical skills and negotiation capabilities
  • Comprehensive understanding of healthcare reimbursement methodologies and managed care models

Responsibilities

  • Manage the Payer Analytics & Economics team, including staff hiring and development
  • Oversee quality control for analytics deliverables related to reimbursement
  • Review and interpret payer contract terms and influence pricing strategies
  • Monitor financial performance of contracts and analyze profitability
  • Provide training and oversight on payer contracts' modeling and analysis
  • Prepare complex financial performance analyses and present results to senior leadership

Benefits

  • Opportunities for professional development and training
  • Collaborative work environment with strategic influence
  • Role in shaping partnerships with health plans
  • Engagement with senior leadership on key decisions
  • Dynamic and complex healthcare environment
Full Job Description
Job Summary and Responsibilities

As our System Manager, Payer, you will provide strategic leadership and expert oversight for all aspects of our organization's payer relations and contracting, ensuring optimal financial performance and sustainable partnerships with health plans. Every day you will manage a team responsible for negotiating, implementing, and monitoring contracts with various governmental and commercial payers across our system. To be successful in this role, you must possess strong analytical and negotiation skills, a comprehensive understanding of healthcare reimbursement methodologies, managed care models, and regulatory requirements, and proven leadership experience in payer contracting and relations within a complex healthcare environment.

  • Manage the labor and operations of the Payer Analytics & Economics team including the hiring, orienting, developing and managing of staff.
  • Oversee quality control and quality assurance of Payer Analytics & Economics analytics deliverables and financial models to support the negotiation and implementation of appropriate reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives.
  • Review and accurately interpret contract terms, including payer policies and procedures to appropriately contract performance and influence strategic pricing strategies.
  • Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability.
  • Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by payer strategy and operations, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes.
  • Oversee and prepare complex 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, provisions, parameters and rate structures aimed at establishing appropriate reimbursement levels. Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision making activities.
Job Requirements

Required

  • Bachelors Other Bachelor’s Degree in Business Administration, Accounting, Finance, Healthcare or related field. or Equivalent education and experience in related field(s) may be considered in lieu of degree.
  • Five (5) years of experience in contributing to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning, and/or healthcare operations.
  • Two (2) years of experience in a supervisory role

Where You99ll Work

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.

Stay Connected with CommonSpirit Health Jobs

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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.

SEARCH COMMONSPIRIT HEALTH JOBS

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Learn more about CommonSpirit Health
Size
10,001 employees
Industry

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