Senior Analyst Payer Analytics and Economics

2 weeks ago

Greenwood Village, United States CommonSpirit Full time
Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities

** Strongly prefer someone in the Eastern or Central time zone**

J OB S UMMARY

The Senior Analyst, Payer Analytics & Economics performs complex managed care payer financial analysis, strategic pricing and payer contract modeling activities for a defined payer portfolio. Provides analytical and pricing expertise for the evaluation, negotiation, implementation and maintenance of managed care contracts between CommonSpirit Health providers and payers. Recommends strategies for maximizing reimbursement and market share. Provides mentorship and guidance of Analyst contract modeling. Provides analysis findings and education to key stakeholders.

This position will serve and support all stakeholders through ongoing educational and problem-solving support for managed care payer reimbursement models. This position requires daily contact with senior management, physicians, hospital staff, and managed care/payer strategy leaders.

E SSENTIAL K EY J OB R ESPONSIBILITIES
  • Lead payer contract modeling strategy and consolidation for large managed care payer negotiations. Act as a liaison between CommonSpirit Health and payer to update information and communicate changes related to reimbursement.
  • Perform complex strategic pricing analysis to support the negotiation and implementation of appropriate reimbursement rates and associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. Develop and approve financial models and payer performance analysis.
  • Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability. Review and accurately interpret contract terms, including payer policies and procedures impacting contract performance.
  • 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.
  • 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, provision, parameters and rate structures aimed at establishing appropriate reimbursement levels.
  • Identify, collect, and manipulate from a wide variety of financial and clinical internal data bases (e.g. PIC, STAR, TSI, PCON, EPIC) and external sources. Identify and access appropriate data resources to support analyses and recommendations.
  • Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision-making activities.
  • Maintain knowledge of operations sufficient to identify causative factors, deviations, allowances that may affect reporting findings. Ability to translate operational knowledge to identify unusual circumstances, trends or activity and project the related impact on a timely, pre-emptive basis.
  • Provides leadership, oversight and training for Payer Analytics & Analyst contract modeling activities.
Pay Range may vary upon geographic location. This is a remote position.

Qualifications

Required
  • Bachelor's Degree in Business Administration, Accounting, Finance, Healthcare or related field. Equivalent education and experience, in related field may be considered in lieu of degree.
  • Minimum of three (3) years of experience in financial healthcare reimbursement analysis is required, including an understanding of national standards for fee-for-service and value-based provider reimbursement methodologies.
  • Working knowledge of financial healthcare reimbursement analysis including an understanding of national standards for fee-for-service and value-based provide reimbursement methodologies.
  • Experience in contribution to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations.
  • Basic technical understanding and proficiency in MS Excel, MS Access, MS Visual Basic, PIC, SQL, or other related applications.
  • Working knowledge of healthcare financial statements and accounting principles.
  • Ability to use and create data reports from health information systems, databases or national payer websites (EPIC, EPSI, PIC, SQL Databases, etc.)
  • Proficiency in reading, interpreting and formulating computer
Preferred
  • Prefer healthcare contract modeling experience

  • Senior Contract Compliance Analyst

    2 weeks ago

    Greenwood Village, United States CommonSpirit Full time

    Overview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...

  • Junior Business Analyst

    6 days ago

    Greenwood Village, United States Brooksource Full time

    Junior Business Analyst Location: Greenwood Village, CO 80111 ( Hybrid – 3 days onsite, 2 days remote) Contract: Long term contract Pay: $30/hr Overview: As a Junior Business Analyst, you will be an integral part of our business operations team, collaborating closely with the Software & Data Platforms (SDP) Business Planning team to facilitate budget...

  • Junior Business Analyst

    6 days ago

    Greenwood Village, United States Brooksource Full time

    Junior Business AnalystLocation: Greenwood Village, CO 80111 (Hybrid – 3 days onsite, 2 days remote)Contract: Long term contractPay: $30/hrOverview:As a Junior Business Analyst, you will be an integral part of our business operations team, collaborating closely with the Software & Data Platforms (SDP) Business Planning team to facilitate budget discussions...

  • Financial Analyst: III

    1 month ago

    Greenwood Village, United States AVA Counsulting Full time

    Job ID - CBNKJP00000786 Job Title: Financial Analyst: III (Senior) Location: Greenwood Village, CO (Hybrid) Duration: 6+ Months Contract Description: We need your financial talent to join our Technology and Data Innovation team helping manage our $101MM annual budget. We have been leveraging Apptio as our budget platform and software to create and manage our...

  • Market Risk Analyst

    2 weeks ago

    Greenwood Village, United States SymphonicHCM Full time

    Our client in Greenwood Village, Colorado is looking for a Market Risk Analyst to join their team! If you enjoy analyzing data to understand the underlying story, and have experience with asset and liability management risk models, this is your PERFECT opportunity! Hybrid role, requiring 1-2 days per week on-site in the Denver Tech Center Relocation...

  • Market Risk Analyst

    2 weeks ago

    Greenwood Village, United States SymphonicHCM Full time

    Our client in Greenwood Village, Colorado is looking for a Market Risk Analyst to join their team! If you enjoy analyzing data to understand the underlying story, and have experience with asset and liability management risk models, this is your PERFECT opportunity!Hybrid role, requiring 1-2 days per week on-site in the Denver Tech CenterRelocation assistance...

  • Market Risk Analyst

    3 weeks ago

    Greenwood Village, United States SymphonicHCM Full time

    Our client in Greenwood Village, Colorado is looking for a Market Risk Analyst to join their team! If you enjoy analyzing data to understand the underlying story, and have experience with asset and liability management risk models, this is your PERFECT opportunity!Hybrid role, requiring 1-2 days per week on-site in the Denver Tech CenterRelocation assistance...

  • Senior Financial Analyst

    5 days ago

    Elk Grove Village, United States LHH Full time

    Candidates that live in the Chicago area will be contacted for this role. If you are interested in this Senior Financial Analyst job in the Chicago area or other accounting and finance opportunities then please forward your resume to Marla.Lampert@LHH.com This manufacturing company is driven by their commitment to their employees and they believe that each...

  • Senior Financial Analyst

    2 weeks ago

    Elk Grove Village, United States LHH Full time

    Candidates that live in the Chicago area will be contacted for this role.If you are interested in this Senior Financial Analyst job in the Chicago area or other accounting and finance opportunities then please forward your resume to Marla.Lampert@LHH.comThis manufacturing company is driven by their commitment to their employees and they believe that each...

  • Senior Financial Analyst

    2 months ago

    Elk Grove Village, United States LHH Full time

    Candidates that live in the Chicago area will be contacted for this role.If you are interested in this Senior Financial Analyst job in the Chicago area or other accounting and finance opportunities then please forward your resume to Marla.Lampert@LHH.comThis manufacturing company is driven by their commitment to their employees and they believe that each...

  • Senior Financial Analyst

    1 month ago

    Elk Grove Village, United States LHH Full time

    Candidates that live in the Chicago area will be contacted for this role.If you are interested in this Senior Financial Analyst job in the Chicago area or other accounting and finance opportunities then please forward your resume to Marla.Lampert@LHH.comThis manufacturing company is driven by their commitment to their employees and they believe that each...

  • Data Analyst

    1 week ago

    Greenwood Village, United States The Select Group Full time

    Sustainability Data Analyst/Business Analyst - Greenwood Village, COProject Details: This candidate will support the data and reporting vertical. They'll do this through quarterly data and reporting for this clients Greenhouse Gas and Carbon emissions to report on their sustainability. This candidate will be working on projects for energy efficiency and...

  • Data Analyst

    1 week ago

    Greenwood Village, United States The Select Group Full time

    Sustainability Data Analyst/Business Analyst - Greenwood Village, COProject Details: This candidate will support the data and reporting vertical. They'll do this through quarterly data and reporting for this clients Greenhouse Gas and Carbon emissions to report on their sustainability. This candidate will be working on projects for energy efficiency and...

  • Data Analyst

    1 week ago

    Greenwood Village, United States The Select Group Full time

    Sustainability Data Analyst/Business Analyst - Greenwood Village, COProject Details: This candidate will support the data and reporting vertical. They'll do this through quarterly data and reporting for this clients Greenhouse Gas and Carbon emissions to report on their sustainability. This candidate will be working on projects for energy efficiency and...

  • Senior Financial Analyst

    4 days ago

    Westlake Village, United States Vaco Full time

    Vaco is partnered with an industry leader in the CPG and retail space, with locations across the United States. This leader is looking to bring on a Senior Financial Analyst to their growing team. This Senior Financial Analyst will dive into supporting budgets, Mo/Quarterly forecasts, audit, analysis, financial reporting, and other areas of strategy &...

  • IT Technical Analyst

    5 days ago

    Greenwood Village, United States CommonSpirit Full time

    Overview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...

  • IT Sr Technical Analyst

    7 days ago

    Greenwood Village, United States CommonSpirit Full time

    Overview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...

  • Compensation Analyst

    6 days ago

    Greenwood Village, United States Oak View Group Full time

    Oak View Group is the global leader in venue development, management, and premium hospitality services for the live event industry. Offering an unmatched, 360-degree solution set for a collection of world-class owned venues and a client roster that includes the most influential, highest attended arenas, convention centers, music festivals, performing arts...

  • Programmer Senior Analyst

    1 week ago

    Westlake Village, California, United States Pleasant Holidays, AAA Careers Full time

    Programmer Senior AnalystPleasant Holidays is one of the largest travel wholesalers in the United States specializing in vacation travel to the Hawaiian Islands, Caribbean, Central America, Europe, Mexico, Middle East, South Pacific (Australia, Cook Islands, Fiji, New Caledonia, New Zealand & Tahiti), Japan, the United States & Canada, and cruise vacations...

  • Accountant Senior

    6 days ago

    Greenwood Village, United States AdventHealth Full time

    Please attach a copy of your resume, license/certifications to your application—thank you! All the benefits and perks you need for you and your family: Benefits from Day One Paid Days Off from Day One Student Loan Repayment Program Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that...