System Manager Payer Analytics Economics
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Job Location:
Phoenix, NM - USA
Monthly Salary:
Not Disclosed
Posted on:
3 days ago
Vacancies:
1 Vacancy
Job Summary
Where Youll Work
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.
Job Summary and Responsibilities
This is a remote position that works predominately Pacific Coast time zone.
As our System Manager Payer you will provide strategic leadership and expert oversight for all aspects of our organizations payer relations and contracting ensuring optimal financial performance and sustainable partnerships with health plans.
Every day you will manage a team responsible for negotiating implementing and monitoring contracts with various governmental and commercial payers across our system.
To be successful in this role you must possess strong analytical and negotiation skills a comprehensive understanding of healthcare reimbursement methodologies managed care models and regulatory requirements and proven leadership experience in payer contracting and relations within a complex healthcare environment.
- Manage the labor and operations of the Payer Analytics & Economics team including the hiring orienting developing and managing of staff.
- Oversee quality control and quality assurance of Payer Analytics & Economics analytics deliverables and financial models to support the negotiation and implementation of appropriate reimbursement rates associated language between physicians/hospitals and payers/networks for managed care contracting initiatives.
- Review and accurately interpret contract terms including payer policies and procedures to appropriately contract performance and influence strategic pricing strategies.
- Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability.
- 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.
- Oversee and 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 provisions parameters and rate structures aimed at establishing appropriate reimbursement levels. Prepare and effectively present results to senior leadership and other key stakeholders for review and decision making activities.
Job Requirements
Required
- Bachelors Other Bachelors Degree in Business Administration Accounting Finance Healthcare or related field. or Equivalent education and experience in related field(s) may be considered in lieu of degree.
- Five (5) years of experience in contributing to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis trend management budgeting forecasting strategic planning in the healthcare industry.
- Two (2) years of experience in a supervisory role
- Strongly prefer hospital or managed care experience
- Requires some experience with SQL queries and Excel. EPIC experience a big plus.
Required Experience:
Manager
Key Skills
- Adobe Analytics
- Data Analytics
- SQL
- Attribution Modeling
- Power BI
- R
- Regression Analysis
- Data Visualization
- Tableau
- Data Mining
- SAS
- Analytics
About Company
Dignity Health provides compassionate, high-quality, affordable health care services throughout Arizona, California and Nevada. Schedule an appointment today!
