Director, Managed Care Analytics

St. Luke's Health System•Boise, ID

61d•Remote

About The Position

Overview Position can be remote from the states of Idaho, Oregon, Utah and Arizona only. The Director, Managed Care Analytics is responsible for the creation and development of detailed financial models, analyses and reports to support third party payer contract negotiations and optimization of the performance of existing third-party payer relationships. Responsible for the development of the necessary reports to identify and assess contract performance trends and operational issues. Responsible for educating staff in various departments on new or amended third party payer contract rates, terms, and conditions. Responsible for the development of a program of cross-training and maintenance of skills in the use of contract modeling information systems. Supports the leadership team in the identification of potential business opportunities, contract negotiations, and payer relationship development. What You Can Expect: Prepare comprehensive reports and presentations to communicate financial findings and recommendations to senior management. Conduct financial modeling and forecasting to assess the impact of proposed contract changes and new initiatives. Monitor and evaluate contract performance and financial metrics, identifying trends, variances, and areas for improvement. Analyze managed care contracts for financial performance, identifying areas for optimization. Generate regular and ad-hoc financial reports, summarizing key data, trends, and recommendations for decision-makers. Lead complex or special assignments related to managed care financial analysis. Provide analytic support across various departments and service lines, ensuring data-driven decisions. Research and resolve inquiries related to assigned functional areas, offering strategic recommendations. Collaborate with finance teams and management to review financial information and forecasts. Apply federal and state regulatory requirements, as well as organizational policies and procedures, to all projects.

Requirements

Bachelor's Degree (math, statistics, business, healthcare administraiton)
10 years of relevant experience

Nice To Haves

A combined minimum of five (5) years’ experience in statistical and financial analyses, report writing, decision support, and/or third party payer contracting is preferred.
Must have knowledge of commercial health plans, Medicaid systems (traditional and managed care), as well as federal Medicare Advantage and commercial health insurance exchange programs.
Must possess strong interpersonal skills as well as strong leadership qualities.

Responsibilities

Prepare comprehensive reports and presentations to communicate financial findings and recommendations to senior management.
Conduct financial modeling and forecasting to assess the impact of proposed contract changes and new initiatives.
Monitor and evaluate contract performance and financial metrics, identifying trends, variances, and areas for improvement.
Analyze managed care contracts for financial performance, identifying areas for optimization.
Generate regular and ad-hoc financial reports, summarizing key data, trends, and recommendations for decision-makers.
Lead complex or special assignments related to managed care financial analysis.
Provide analytic support across various departments and service lines, ensuring data-driven decisions.
Research and resolve inquiries related to assigned functional areas, offering strategic recommendations.
Collaborate with finance teams and management to review financial information and forecasts.
Apply federal and state regulatory requirements, as well as organizational policies and procedures, to all projects.