Senior Analyst Payer Strategy and Contracting

3 weeks ago

Boston MA, United States Mass General Brigham Full time

DescriptionAbout UsAs a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women’s Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care, and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research. We’re focused on a people-first culture for our system’s patients and our professional family. That’s why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees’ personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development—and we recognize success at every step. Our employees use the Mass General Brigham values to govern decisions, actions, and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration. The Sr. Analyst provides analytic support for value-based care models including Accountable Care Organizations (ACO), bundled payments, payer demonstration projects, risk contracts and other alternative payment arrangements. In addition, the Sr. Analyst will be responsible for creating and supporting payment models that align with MGB system strategic pricing priorities. This will be accomplished by investigating key business problems through quantitative analyses of utilization, billing, and payer claims data. The Sr. Analyst will develop presentation materials laying out the context of issues under discussions, analytic findings, options, and recommendations to inform leadership decision making.  Other responsibilities include monitoring and reporting on key market trends, using resources like Price Transparency reports on relative prices, health care expenditures, state cost hearing reports, health plan enrollment trends and financial performance and supporting senior management on specialized projects and program evaluation.Essential Functions:Providing analytic support for value-based care models including Accountable Care Organizations (ACO), bundled payments, payer demonstration projects, risk contracts and other alternative payment arrangementsCreating and supporting payment models that align with system strategic pricing prioritiesInvestigating key business problems through quantitative analyses of utilization, billing, and payer claims dataDeveloping presentation materials laying out the context of issues under discussion, analytic findings, options, and recommendations, to inform leadership decision makingMonitoring and reporting on key market trends, using resources like Price Transparency reports on relative prices, health care expenditures, state cost hearing reports, health plan enrollment trends and financial performanceSupporting senior management on specialized projects and program evaluationQualificationsQualifications: Bachelor's degree required in business, health care administration, finance or related fields. Master’s degree preferred. Experience in lieu of education accepted. 4 years in analytical and database experience, preferably in a healthcare environment.Skills/Abilities/Competencies: Superior analytical and problem solving skills. Ability to develop well thought out analyses that address the project objective and are easily manipulated to keep pace as the work evolves, proactive questioning and investigation of anomalous results, and consideration of alternative solutions or various analytical paths.Advanced technical skills.  Proficient in Access or other relational databases.  Ability to navigate various systems, pull and aggregate data using sophisticated software functionality including but not limited to manipulation of large data sets. Expertise in Microsoft Excel, including formulas, calculations, pivot tables, charts, graphs, etcKnowledge of physician and hospital reimbursement, medical terminology, ICD 10, CPT and HCPCS coding and value-based care methodologies preferred.Ability to work independently and manage multiple responsibilities in complex environment. Strong organizational and project management skills.  Able to manage multiple projects and deadlines.  Effectively use various tools to initiate a project, monitor progress, anticipate obstacles and provide concise updates in a timely manner. Strong communication skills, with the ability to turn data into actionable information in an accurate, reliable and timely manner and present findings and recommendations. Ability to explain complex analytic issues and present findings and recommendations to various levels of management#LI-Remote Job Field: Data/AnalyticsOrganization: Mass General BrighamSchedule: Full-timeShift: Day JobEmployee Status: Regular

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