Senior Payer Contract Analyst (Full-TimeDay) Hybrid

Job Details

Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations monitor contract performance and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve aggregate and analyze data from multiple sources using a variety of tools to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.

Job Description

Schedule: Monday - Friday 8:00 am - 4:30 pm.

Hybrid: Travel to the location quarterly

Summary
Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations monitor contract performance and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve aggregate and analyze data from multiple sources using a variety of tools to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.

Job Duties

• Conduct detailed managed care contract modeling and analysis using available contract modeling systems.
• Build flexible models that aggregate fee-for-service and value-based data from multiple sources and enable scenario play.
• Maintain key department metrics (e.g. Managed Care Financial Reporting package payer mix reimbursement benchmarks) and monitoring tools ( and rate tracking grids).
• Ensures compliance with all CMS Price Transparency requirements relating to development accuracy and publication of machine-readable files.
• Monitor payer policy updates and quantify impact of potential material harm and/or other contract implications.
• Validate payer rate loads to ensure contracts are being executed accurately and perform root-cause analysis of variances.
• Serves as a resource to management to assist in ad-hoc projects.

Minimum Qualifications

• Bachelors Degree Finance Healthcare Administration Business or related field
• 5 years Experience in payer related position(s) in provider or insurance industry with minimum 5 years experience in budgeting insurance/payer related financial analysis net revenue reimbursement modeling and performance computations decision support and general financial reporting.
• Intermediate to advanced capabilities with Microsoft Excel and PowerPoint
• Experience building and manipulating Contract Modeling tools and BI/Data Analytics applications (e.g. Qlik Tableau Microsoft PowerBI EPSi).
• Ability to thrive in a fast-paced agile work environment with high expectations and accountability.
• Excellent written and verbal communication skills.
• Efficient conceptualization analytical and logic skills.

Preferred Qualifications

• Masters Degree Finance Healthcare Administration Business or related field

Additional Qualifications

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing frequent keyboard use *patient care providers may be required to perform activities specific to their role including kneeling bending squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities requirements and working conditions for the position. It is intended to be an accurate reflection of the current position however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University Hospitals Inc.

Primary Location Address

1101 Market Philadelphia Pennsylvania United States of America

Nationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

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