Senior Financial Analyst-Managed Care

POSITION SUMMARY:
The Sr.

Financial Analyst, Managed Care, drives analytics and decision support in assigned regions by translating real world payer contract rates, terms, volume, utilization trends, and network development challenges into actionable insights to assist in the strategic positioning of revenue, payer contracts, and overall network strategy.

The Sr.

Financial Analyst works closely with Managed Care leaders to prioritize needs of assigned regions and ensure provision of timely and accurate deliverables.
ESSENTIAL FUNCTIONS: To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.
Model hospital, physician, and ancillary payer contracts using Excel and/or other managed care modeling tools to quantity contractual value and changes in contractual value.

Collaborate with Managed Care leaders to report the financial impact of changes in fee-for-service and value-based contract rates and terms to allow the team to make informed decisions during negotiations with insurance payers.

The Sr.

Financial Analyst will be expected to understand and translate complex contracts and payment methodologies.
Utilize various and several Business Intelligence (BI) tools to gather, manipulate, and analyze data to provide insight into payer contract performance.
Summarize reimbursement by payor, facility, insurance plan, etc., to analyze underpayments or other various payment scenarios.
Design, develop, and deliver ad hoc reporting and analysis, including payer policy quantitative and qualitative impact analysis, service line volume trends, litigation support, chargemaster optimization, and other analysis as needed.

Update standard managed care and revenue cycle reports per their reporting schedule or as needed.
Build reporting models requiring an understanding of business processes, reporting needs, and a complex information system.
Assist with training and mentoring of other analytic staff.
Review and abstract contract term language that significantly impacts hospital reimbursement.
Coordinate with managed care negotiators to identify all updates to managed care contracts.

Distribute new and updated managed care contracts to impacted stakeholders (internal and external).

Research and/or locate missing information related to managed care contracts.
Regular and reliable attendance.
Perform other duties as assigned.
Additional Information:
Position serves both internal co-workers and external customers, clients, patients, contractors, and vendors.
Access to and/or works with sensitive and/or confidential information.
Exhibit an understanding of healthcare regulatory and compliance (e.g., HIPAA).

Skilled in the application of policies and procedures.

Knowledge of Business Office Standards and Recommended Practices.
SUPERVISORY RESPONSIBILITIES:
Not responsible for supervising employees.
KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.
Education: Bachelor’s Degree
Bachelor’s Degree required (Business, Mathematics, Engineering, Finance, Information Systems, or other quantitative field of study)
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*Experience: *
3+ years
Certifications:
N/A
Licenses:
N/A
Skills and Abilities:
Mathematical Skills
Business Mathematical Skills
– Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

Ability to compute rates, ratios, and percentages and to draw and in-terpret graphs.

Computer Skills
Technical Computer Skills
– Demonstrate use of intermediate computer operations (basic programming, relation-al databases, and operating systems) and intermediate software packages.

Communication
Moderate Communication
– Regularly uses moderately complex oral and written skills.

May train others in func-tional areas, interact with others and make presentations to department or middle management.

Decision Making
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*Department Specific Impact
– Decisions impact the management and operations within a department.

May con-tribute to business and operational decisions that affect the department.*
Nature of Problems
**
*Varied Business Problems
– Problems are varied and complex, requiring analysis or interpretation of the situation.

Problems are solved using knowledge and skills, general precedents and practices.*
Independent Judgement
Moderate Independent Judgement
– Results are defined; sets personal own goals and determines how to achieve results with few or no guidelines to follow; supervisor/manager provides broad guidance and overall direction.

Planning/Organization
Project Management
– Handle multiple projects simultaneously including task delegation, project oversight, and resource allocation.

PHYSICAL AND MENTAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, bend, crouch or crawl; talk or hear; taste or smell.

The employee must occasionally lift and/or move up to 20 pounds.

Repetitive motion of upper body required for extended use of computer.

Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
WORK ENVIRONMENT AND TRAVEL REQUIREMENTS:
Work environment characteristics described here are representative of those that an employee may encounter while performing the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.
Works in well-lit, ventilated and climate controlled office environment with routine office equipment; some equipment has moving mechanical parts.
In hospital environment, may be exposed to hazards and unusual elements, which may include but are not limited to bloodborne pathogens and / or contagious illnesses, toxic chemicals, and biohazardous materials which may require extensive safety precautions and the use of protective equipment.
Noise level in the work environment is typical for an office and/or hospital environment.
Travel:
Minimum overnight travel (up to 10%) by land and/or air
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*Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran*

Location: 330 Seven Springs Way

Job Type: Full-time