Strategic Healthcare Financial Analyst

1 week ago


Maitland, Florida, United States Adventhealth Full time
Job Description:

We are seeking a highly skilled Strategic Healthcare Financial Analyst to join our team at AdventHealth. As a key member of our managed care team, you will be responsible for analyzing and evaluating financial and economic data related to healthcare costs and managed care payer rates and reimbursement.

Schedule:

This is a full-time position working 1 day shift in Altamonte Springs, FL.

About the Role:

The Senior Medical Economics analyst is responsible for analyzing and evaluating financial and economic data related to healthcare costs and managed care payer rates and reimbursement. The role focuses on financial trends, reimbursement methodology, data tools, modeling, and managing revenue. Must be able to complete extensive and complex financial and operational analyses of managed care contracts and proposals, analyze fee schedules, and determine contract compliance. The Senior Medical Economics analyst must have attention to detail and competencies in decision support and reporting through converting raw data into meaningful applications to support executive decision making.

Responsibilities:

- Research and analyzes managed care data from the various financial systems and interface tools
- Performs analysis of complex and varied healthcare data including financial modeling and risk forecasting
- Work to identify/implement improvements in quality control/timeliness of reporting
- Extracts, collects, analyzes and interprets health utilization and financial data of various types
- Interpret an analyze data from various sources using knowledge of healthcare managed care contracts and healthcare administrative claims data
- Employs existing complex models and implements them on new projects and/or new contexts and she/he designs new solutions for data and analytic challenges the organization faces
- Support the negotiations of capitated and other VBA agreements between physicians/hospitals and payers/networks through detailed data analytics
- Develop financial models and inform VBA negotiations parameters and Evaluate possible changes to key terms in existing value based agreements
- Identify risk/exposure associated with various reimbursement structures. Produce prospective analyses an new venture, products, and service offerings
- Prepare and effectively present analytics or project results to key stakeholders for review and decision-making
- Evaluate and understand contract language as it relates to reimbursement methodologies for the full spectrum of app provider types

Requirements:

- Bachelor's degree in Finance, Health Care Administration, Accounting, Mathematics, or Health and Informatics or related field required
- Master's Degree in a related field preferred
- Minimum of four (4) years' experience performing data, financial and/or risk analytics in a healthcare environment
- Working knowledge of value-based arrangements, including shared savings, bundled payments, pay-for-performance, and capitation strongly preferred
- Working knowledge of population health, utilization measurement, and claims analytics strongly preferred.
- Managed Care, Patient Financial services, health insurance claims processing, contract management, or medical economics required
- Proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms
- Experience in modeling financial impact of changes
- Strong ability to handle multiple projects including problem solving, research, analysis, and communication in a fast-paced environment
- Intermediate level of proficiency working with MS Excel including Formulas, calculations, charts, and graphs
- Strong skills in analytical/problem solving and presentations required

Benefits:

All benefits and perks you need for you and your family:
- Benefits from Day One
- Paid Days Off from Day One
- Student Loan Repayment Program
- Career Development
- Whole Person Wellbeing Resources
- Mental Health Resources and Support

About AdventHealth:

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. We are a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Salary Range:

$83,000 - $113,000 per year

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