Payer Analytics Strategy Initiatives Analyst
Payer Analytics Strategy Initiatives Analyst
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Job Description
Overview
Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nations largest nonprofit Catholic healthcare organizations CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2300 clinics care sites and 137 hospital-based locations in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157000 employees 45000 nurses and 25000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care community benefits and unreimbursed government programs. Together with our patients physicians partners and communities we are creating a more just equitable and innovative healthcare delivery system.
Responsibilities
Job Summary / Purpose
The Payer Analytics Strategic Initiatives Analyst plays a critical role in advancing CommonSpirit Healths managed care strategy through a blend of financial analysis payer contract modeling and strategic insights. Payer Analytics Initiatives is a multi-dimensional dynamic department with an emphasis on problem-solving and special project focus. This position is responsible for evaluating and supporting negotiations across a diverse payer portfolio including commercial Medicare Medicaid Health Insurance Exchange plans and more. The Analyst leverages analytical tools such as PIC and EPIC and manages their integration with internal Core Analytics Tools to inform contract strategy optimize reimbursement and identify risks and opportunities in payer arrangements.
The role supports internal stakeholders through customized analyses market intelligence synthesis and proactive insights that guide payer strategy formation. In addition to leading structured initiatives the analyst performs ad hoc analysis to support real-time negotiation efforts strategic pricing scenarios dispute analytics and the development of termination or alternative payment strategies. The position works closely with senior management Payer Strategy negotiating teams and cross-functional teams within and outside of the Payer Strategy and Analytics (PSA) group to develop data-driven solutions that enhance financial performance strengthen provider-payer relationships and support the organizations mission to improve community health outcomes.
Essential Key Job Responsibilities
- Support Cross-Functional Payer Strategy Projects: Contribute to initiatives that span Payer Strategy & Analytics reimbursement modeling and contract performance evaluationprojects designed to have broad impact across the Payer Analytics & Economics (PAE) team.
- Develop and Maintain Analytical Tools and Models: Assist in building refining and managing analytical tools within PIC EPIC and our Core Analytics Tools environment. Help create standardize and document key workflows.
- Lead Special Projects and Strategic Initiatives: Assist with quick-turnaround analyses and presentations that support executive or regional decision-making including scenario modeling contract term reviews and negotiation support. Contribute to high-priority initiatives pilot programs and other special projects that drive innovation in payer strategy at the direction of PSR leadership.
- Engage in Process Improvement and Problem Solving: Participate in identifying gaps inefficiencies or inconsistencies in our analytics workflows and contribute to developing scalable solutions that improve speed quality and insight generation.
- Collaborate on Strategic Insights and Reporting: Help synthesize internal performance data market intelligence and payer insights to support the development of strategy documents dashboards and custom analyses for leadership and regional partners.
- Contribute to Training and Knowledge Sharing: Support the development and rollout of training programs related to PIC EPIC and Core Analytics Toolseventually serving as a resource for team education even while continuing to grow into the technical depth of the role.
- Coordinate with Key Stakeholders: Work alongside other analysts contract negotiators and regional stakeholders to ensure alignment of data strategy and goals across projectsserving as a connector between the technical and strategic aspects of the departments work.
- Assist with Contract and Reimbursement Analysis: Support modeling of reimbursement scenarios and strategic pricing analyses to inform payer negotiations evaluate contract performance and highlight financial risks or opportunities.
Qualifications
Required Education and Experience
- Bachelors Degree in Business Administration Accounting Finance Healthcare or related field. Equivalent education and/or experience may be considered in lieu of degree.
- Minimum of one (1) year 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.
Required Minimum Knowledge Skills Abilities and Training
- Experience in financial healthcare reimbursement analysis is required 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 and mathematical rules/formulas.
Required Experience:
IC
Employment Type
Unclear
