Payor Contracting Analyst Senior, Finance-Payer Contracting

2 months ago

Minneapolis, United States Hennepin County Medical Center Full time

Hennepin Healthcare is an integrated system of care that includes HCMC, a nationally recognized Level I Adult Trauma Center and Level I Pediatric Trauma Center and acute care hospital, as well as a clinic system with primary care clinics located in Minneapolis and across Hennepin County. The comprehensive healthcare system includes a 473-bed academic medical center, a large outpatient Clinic & Specialty Center, and a network of clinics in the North Loop, Whittier, and East Lake Street neighborhoods of Minneapolis, and in the suburban communities of Brooklyn Park, Golden Valley, Richfield, and St. Anthony Village. Hennepin Healthcare has a large psychiatric program, home care, and operates a research institute, philanthropic foundation, and Hennepin EMS. The system is operated by Hennepin Healthcare System, Inc., a subsidiary corporation of Hennepin County.

Equal Employment Opportunities: We believe equity is essential for optimal health outcomes and are committed to achieve optimal health for all by actively eliminating barriers due to racism, poverty, gender identity, and other determinants of health. We are committed to equitable care and working in an environment that celebrates, promotes, and protects diversity, equity, inclusion, and belonging. We are committed to bringing in individuals with new cultural perspectives to assist in creating a more equitable healthcare organization.

SUMMARY:
We are currently seeking a Payor Contracting Analyst Senior to join our team in this full-time role.

Purpose of this position: Responsible for integrating payor policy, procedure and contract requirements within the Payor Relations and Contracting department. Involves working with Payor Relations Director to develop seamless contracting cycle with payors and implementing contractual changes as needed. Leads team on major projects as they arise.

RESPONSIBILITIES:

  • Assist Payor Contracting Director with developing and implementing Hennepin Healthcare's overall payor contracting strategies
  • Support Payor Contracting Director and Hennepin Healthcare leadership in negotiation of third-party payor contracts including direct involvement in negotiations
  • Develop, document, standardize and maximize the use of financial contract modeling tools including the support of Hennepin Healthcare departments requesting reimbursement analysis related to payor contracting. Develop and maintain payor contracting onboard, off boarding, and change control workflows for Hennepin Healthcare 3rd Party Payors
  • Create and analyze contract models identifying incremental revenue opportunities with improved payor contracts
  • Catalogue and interpret contracts with third party payors and analyze internal compliance
  • Develop and prepare routine management reports monitoring performance, expenditures, and payor productivity
  • Prepare responses to special project requests including development of assumptions, identification of analysis format and inclusion of recommendations based upon the analysis of a project
  • Leads team on major projects as they arise
  • Assist Executive leaders, Finance Department, Revenue Cycle, Physician Services, and other departments as requested with special projects
  • Work with Payor Contracting team to develop staff training and documented resources to maximize payor expertise within the respective areas of the department
  • Other duties as assigned

QUALIFICATIONS:

Minimum Qualifications:

  • Bachelor's degree in business administration, Accounting, or related area
  • 5+ years of professional experience in health care reimbursement, financial management including experience with computer financial applications

-OR-

  • An approved equivalent combination of education and experience

Preferred Qualifications:

  • Experience leading teams and working with consultants on major programs and projects
  • Previous payor experience in finance, network management, or provider contracting
  • Previous hospital/ clinic finance or contracting analytical modeling experience
  • 5+ years' experience with SQL based tools and or EPIC
  • Previous healthcare billing or coding experience
  • Strong reporting skills
  • Strong analytical skills

Knowledge/ Skills/ Abilities:

  • Expert knowledge of MS Excel, and experience in MS Word, MS Access (relational databases), MS PowerPoint, and other reporting tools
  • Knowledge of all third-party requirements, state, and federal regulations
  • Knowledge of payor enrollment processes
  • Knowledge of government and commercial payor requirements for accurate and compliant charging and billing of hospital inpatient, outpatient, surgical and ancillary services
  • Knowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting)
  • Knowledge of regulatory publications, how to access and interpret
  • Knowledge of medical terminology
  • Strong analytical and problem-solving skills
  • Ability to work independently, prioritizing and organizing work
  • Strong verbal and written communication skills

License/Certifications:

  • Epic certification

You've made the right choice in considering Hennepin Healthcare for your employment. We offer a wealth of opportunities for individuals who want to make an impact in our patients' lives. We are dedicated to providing Equal Employment Opportunities to both current and prospective employees. We are driven to connect talented individuals with life-changing career opportunities, enabling you to provide exceptional care without exception. Thank you for considering Hennepin Healthcare as a future employer.

Please Note: Offers of employment from Hennepin Healthcare are conditional and contingent upon successful clearance of all background checks and pre-employment requirements.

Primary Location: MN-Minneapolis-Downtown Campus Standard Hours/FTE Status: FTE = 1.00 (80 hours per pay period)Shift Detail: DayJob Level: StaffEmployee Status: Regular Eligible for Benefits: YesUnion/Non Union: Non-Union Job Posting: Jul-23-2024
EEO/Disability/Veteran employer.

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