Senior Contracting Analyst Lead

Mount Sinai is one of the largest U.S. health systems with a strong reputation for quality of care and research.  We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients.

We are accelerating a transition to a business model focused on population health management – our goal is to keep entire communities healthy and out of the hospital. Mount Sinai Health Partners (MSHP) is the team driving this transformation within Mount Sinai.  The team includes 400+ employees with clinical, contracting, finance, IT, analytics, operations, and product development expertise. 

MSHP is a fast growing business unit within Mount Sinai and is looking for team members who:

• Are comfortable "playing up" and "playing down" as needed to accomplish business objectives
• Work productively amidst ambiguity
• Thrive in fast-paced  work environments
• Seek to improve the status quo 

What We Offer

• Opportunity for advancement within MSHP team
• Opportunity to work directly with senior leaders from across the Mount Sinai Health System and external organizations
• Opportunity for mentorship from senior MSHP leaders
• Opportunity to be part of a forward-thinking team driving a system-wide transformation
• Opportunity to work at the forefront of innovation in healthcare

The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans.  The team serves as MSHP's subject matter experts on: Facility related Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of implementing Facility and Ancillary Contracts across the Mount Sinai Health System.

MSHP seeks a Senior Contracting Analyst Lead to analyze and report the financial performance for all Commercial and Medicare Contracts with Mount Sinai. The Senior Contracting Analyst has responsibilities that include: analyzing medical and pharmacy trends, researching all facility amendments, procuring all financial data necessary for driving Mount Sinai's Facility models, and reconciling financial data.  The Senior Contracting analyst is also expected to liaise and coordinate with other departments in Mount Sinai Health Partners.

• Serve as a subject matter expert on contract modeling, payment methodologies, pricing strategy, market competitive intelligence and payer negotiation strategies. 
• Own the development and execution of pricing strategies in payer contract negotiations.
• Mentor analysts in payment methodologies, and payer negotiation strategies by providing guidance, reviewing work, and offering structured feedback.
• Apply strong understanding of payer pricing models and payment methodologies to inform contract negotiations and support the development and implementation of pricing strategy.
• Own the development and execution of pricing strategies in payer contract negotiations.
• Lead knowledge-sharing sessions and develop training materials for team skill development.
• Research from the original contract amendments all financial terms.
• Procure and upload all financial data into Experian Contract Manager Tool to determine financial performance.
• Model Payer Proposals in Experian Contract Manager Tool.
• Reconcile budgeted revenue vs actual revenue collected.
• Perform Root Cause Analysis on medical and pharmacy trends for all contracts.
• Create Power Point Presentations detailing any analysis regarding facility contracting performance.
• Collaborate and liaise with other departments such as Commercialization, Finance, and Patient Accounts.
• Responsible for overall management and delivery of the business plan.  Financial analysis and creation of reports as requested by department administrator or chairman as applicable
• Compiles productivity, compliance and profit/loss reports
• Analyzes revenues to identify collection problems, billing issues and other trends.
• May be well versed and take a proactive role in the revenue cycle, which includes all administrative and clinical functions that contribute to the capture, management and collection of patient service revenue, including overseeing those who may counsel patients on how best to meet their financial obligations.
• Reviews processes and makes recommendations to implement effective changes in procedures and policies.
• Assists with or leads special projects and provides analytical support.
• Performs other related duties.

Education

• HS/GED; Bachelors strongly preferred. Additional experience needed in addition to ?experience requirements? in lieu of education.

Experience

• At least seven years of experience in healthcare analytics required 
• 4 years? experience with payer pricing models and payment methodologies required.
• 4 years? experience developing and executing payer pricing strategies required.
• Health plan experience in Medical Economics or Value Based Payments preferred. 

Additional Skills and Qualities

• Understanding of Excel functions such as VLOOKUP, Pivot Tables, and SUMIFS required.
• Basic understanding of statistical concepts such as per capita, weighted averages, variances, and forecasting required.
• Experience analyzing Facility, Professional and Pharmacy cost trends preferred.
• Familiarity with amendments between payers and providers preferred.
• Firm understanding of Facility, Professional and Pharmacy claim reimbursement preferred.
• Oral presentation experience, especially with senior management, preferred.
• Understanding of data and financial reconciliation preferred.

Non-Bargaining Unit, E01 - Partner MSO Services - MSH, Mount Sinai Hospital