Contract Modeling Analyst

Ardent Health•Brentwood, TN

15d

About The Position

Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states. POSITION SUMMARY: The Contract Modeling Analyst will provide decision support to management for new and or changing reimbursement rates. In coordination with Managed Care, the Contract Modeling Data Analyst will provide modeling scenarios needed during contract negotiations by using both complex data models and a contract modeling system. This position will analyze yields of scenarios and monitor the alignment of billing with contract terms and assist in developing rates and terms within the contract management system to meet targeted increases. Analysis of service lines and cost components is also an integral part of this position.

Requirements

Bachelor's Degree.
4+ years of analytical experience in financial analysis, health care pricing, network management, health care economics
2+ years of experience in creating and using financial modeling tools, spreadsheets or other related systems/tools including experience in interpreting modeling results to inform decisions in negotiations
Experience working with data integration and self-service data preparation, models, and analytics.
Knowledge of Payer products and product differentials
Understands details of various reimbursement methodologies common to managed care payers as well as Government payers

Nice To Haves

Accounting, Finance or Business degree, preferred.
Epic Patient Accounting system, Nthrive Contract Management, and SAP Business Objects experience, preferred.

Responsibilities

Conducts financial modeling, analysis and reporting related to managed care contract negotiations
Concisely summarizes and communicates the results of modeling activities in time sensitive environment
Maintains working knowledge of current Modeling, Data Warehouse and Patient Accounting systems.
Mine data from multiple sources with multiple criterion and performing detailed analysis to verify the completeness and accuracy of the data and evaluate the data in the context of the designated project.
Performs review of contracts and monitor financial performance and compliance to negotiated rates to ensure net revenue was realized to aid in preparation of upcoming negotiations.
Assists with contract negotiation process by analyzing trends in current reimbursement and potential changes needed to have positive impact or improvement to reimbursement.
Analyzes service line information by payer to understand volumes and rate shortfalls compared to costs.
Prepares ad hoc reports around payer performance.
Fosters relationships with facility/market and corporate personnel to understand market operations and similarities with payer contracts.
Coordinates with other Contract Management staff for understanding of contract intent when programming rates into the Production contract management system.