Managed Care Analyst I

1 week ago

Somerville, United States Mass General Brigham (Enterprise Services) Full time
Description

As 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 Managed Care Analyst I will support the Government Payer team by providing analyses related to the state and federal regulatory requirements, emergent health care policy and reform, and ongoing maintenance of Mass General Brigham agreements with public payers. The team is involved in a variety of projects, which may include research and analysis of issues related to hospital and physician fee-for-service reimbursement, fiscal modeling and projections associated with government policy proposals, and system-wide information gathering for regulatory compliance. This position contributes to the presentation of findings and recommendations to a wide range of constituents, including corporate level business leaders. Specific job duties include:

  • Provide analytic support to a variety of project work such as the following:
    • Fiscal impacts of rules issued by Medicare on inpatient, outpatient, physician fee schedules, and home health rates and policies.
    • Evaluation of the impact on reimbursement of innovative payment structures.
    • Utilization data to predict policy impacts and potential business exposures.
    • Assessment of payer contract margin performance for Mass General Brigham facilities, including analysis of key trend drivers
    • Production of inputs to Mass General Brigham annual budget and long-range forecasting processes

  • Assist with documentation of fiscal and operational impacts, including specifics of hospital and physician reimbursement, regulatory requirements and potential systems requirements.
  • Drive cross-system information gathering on mandated government reports and certifications.
  • Assist with the development of presentation materials to lay out the context of issues under discussion, analytic findings, options, and recommendations, such that leadership is well informed and able to make decisions.
  • Maintain constructive, professional relations with key internal constituents, effectively representing Mass General Brigham and the Government Payer Policy team.
  • Participate in other Payer Contracting projects as needed.
  • Other duties as assigned
Qualifications

Qualifications

  • Bachelor's degree is preferred in business, health care administration, public health or related fields
  • One year academic or professional analytic and database healthcare experience (Access or comparable software product) is preferred
  • A working knowledge and understanding of hospital/physician reimbursement methodologies and/or Medicare operations is preferred
  • Experience with building relationships across many intra-company departments with a variety of constituencies and priorities is preferred.
  • Intermediate competency in use of Excel and basic competency in Word and Power Point strongly preferred.
  • A combination of education and experience may be substituted for requirements

Skills/Abilities/Competencies:

  • Basic understanding of the healthcare market as context for analytic responsibilities; includes facts, concepts and trends that are general to the industry and specific to Mass General Brigham and the work of the team
  • Strong quantitative and analytic skills, with the ability to understand complex concepts and attention to detail. Prior experience or at least skills for the use of sophisticated software functionality including but not limited to manipulation of large data sets, database management, experience with querying language and financial modeling.
  • Strong communication skills, with the ability to break down and explain complex analytic issues and present findings and recommendations.
  • Excellent customer service skills: understands customers' needs, provides accurate and reliable information to constituents and maintains professional relationships with key contacts.
  • Ability to think strategically and critically; to develop well-reasoned conclusions, test against relevant criteria/standards and assess in context of the environment and organizational priorities
  • Organized, with basic project managements skills; able to manage multiple concurrent projects and deadlines. Effectively use various tools to initiate a project, monitor progress, anticipate obstacles and provide concise updates in a timely manner.
  • Ability to work with minimal supervision in a complex, sometimes fast-paced environment. A self-motivated and resourceful attitude, taking intellectual ownership of work and the projects. Proactive in identifying issues, prepared to address concerns/questions, and make recommendations.
  • Ability to understand complex concepts, attention to detail, strong technical skills and the ability to work as part of a team in a matrix environment.
EEO Statement

Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives, and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under the law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment.

Primary Location: MA-Somerville-MGB Assembly Row Work Locations: MGB Assembly Row 399 Revolution Drive Somerville 02145 Job: Data/Analytics Organization: Mass General Brigham Schedule: Full-time Standard Hours: 40 Shift: Day Job Posted Shift Description: Eastern business hours required Onsite once per week on Tuesdays for meetings. Employee Status: Regular Recruiting Department: MGB Payer Strategy and Contracting Job Posting: Oct 2, 2024

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