Healthcare Payment and Financing Analyst

Public Health Solutions • New York, NY

1d • Hybrid

About The Position

The New York City Department of Health and Mental Hygiene (NYC DOHMH) is a large public health agency serving 8 million New Yorkers. They are undertaking a new initiative funded by the Centers for Disease Control and Prevention (CDC) to modernize infrastructure and make strategic investments in public health. This initiative aims to improve foundational capabilities and data infrastructure to support better public health outcomes. The selected candidate will be an employee of Public Health Solutions (PHS), a nonprofit organization managing the grant, but will work under the supervision of DOHMH. This is a grant-funded position ending in November 2027.

The Center for Health Equity and Community Wellness (CHECW) focuses on eliminating racial inequities in premature mortality, particularly in chronic diseases, by addressing social and environmental factors. CHECW works on place-based investments, influencing the health system for whole-person care, addressing unhealthy consumption, and improving the built environment. CHECW includes various bureaus focused on neighborhood health, chronic disease prevention, health equity, equitable health systems, and finance/administration.

As public health emergencies become more frequent and severe, DOHMH must enhance its emergency response capabilities. This involves strengthening systems, processes, and policies to build a robust emergency infrastructure, informed by lessons from the COVID-19 pandemic and other emergencies. Emergency preparedness is a foundational public health service that DOHMH must build capacity in to protect public health.

Requirements

• Advanced degree (masters, MD, PhD, DrPH, JD) in business, public health, health policy & management, healthcare finance, economics, or similar.
• 3+ years of experience in roles that provide in-depth understanding of financial incentives in the healthcare delivery and payment systems.
• 3-5 years’ experience in progressively complex healthcare policy analyses.
• 3+ years of experience analyzing Medicaid and/or Medicare Federal/State regulation.
• Experience doing research or analysis of healthcare policy.
• Experience in policy and program planning, development, and implementation.
• Experience producing briefs, memos, and reports.
• Ability to rapidly self-teach software products.
• Highly analytical and detailed oriented.
• Understanding of health care performance metrics and key operating indicators.
• Knowledge of statistical and financial metrics in a health care environment such as payor mix.
• Health Insurance experience and proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms.
• Some experience in social service or community-based organizations, preferably related to contracting with government and/or insurance companies.
• Effective communication and ability to translate financial information to non-financial customers (internal and external).
• Strong ability to handle multiple projects including problem solving, research, analysis, and communication in a fast-paced environment.

Nice To Haves

• Demonstrated knowledge in emerging ways to utilize electronic data for collaborative delivery and payment models (e.g. RHIOs).
• Advanced use of Microsoft Excel.
• Experience in Management Service Organizations, Independent Practice Associations, or other shared service organizations.

Responsibilities

• Perform a variety of policy analyses of the financial incentives and payment innovations necessary to improve equity in healthcare access, outcomes, and healthcare accountability.
• Analyze provider payment and financing strategies for addressing health inequities and achieving health equity.
• Analyze the implementation of New York State 1115 Medicaid waiver, state plan amendments (SPA), and additional initiatives with an equity focus and promoting place-based interventions.
• Support the development and implementation of a Maternal Home Collaborative, a payment model to address maternal mortality and morbidity, with potential co-location with CBO partner(s) and NYC Health Department.
• Support community and social services organizations to expand into a social care delivery system for Medicaid and other payors in a financially sustainable way.
• Facilitate the inclusion of healthcare, preventive, and social care services into alternative payment models like value-based payment (VBP) and capitated arrangements, including through blending and braiding approaches.
• Conduct policy, financing, and research analyses, including literature reviews, landscape analyses, reports, legislation, briefings, memos, and publications.
• Investigate various healthcare payment and financing topics including Medicaid/Medicare payment and credentialing, alternative payment models, and disproportionate share payments.
• Perform policy and financing analyses and literature reviews of the impact of payment and financial policy changes and innovation nationally on quality and population health outcomes.
• Create payment and finance policy goals, including preparing projected analyses on claims and utilization, risk analyses to assist in planning for partner-led population health interventions.
• Lead policy analyses of healthcare payment and financing initiatives, policies, and legislation.
• Prepare briefs, reports, and presentations.
• Lead program development and implementation for healthcare payment and financing initiatives.
• Lead, facilitate, and coordinate meetings with stakeholders, including scheduling, preparing presentations, taking notes, and providing follow-up.
• Participate as an Office of Healthcare System Strategy and Accountability (OHSSA) representative in workgroup(s).
• Support implementation of the Maternal Home Collaborative, a novel model to address maternal mortality and morbidity.
• Collaborate with stakeholders to identify key segments of the population, providers, and services to target for high-value interventions.
• Support the creation of a unified and operationally feasible vision for the delivery of health-related social needs services to maximize impact on population health outcomes.
• Work with payers, providers, and community-based organizations to co-create payment models for health equity innovations, including blended and braided funding.
• Develop payment and financial analysis skills among policy and data analysts.
• Provide analysis of the unintended financial implications of policy and programs for the health department.
• Investigate innovations in healthcare delivery and financing nationally and assess their appropriateness and feasibility for implementation in New York.
• Perform additional duties as assigned.

Benefits

• Hybrid Work Schedule.
• Generous Paid Time Off and Holidays.
• An attractive and comprehensive benefits package including Medical, Dental and Vision.
• Flexible Spending Accounts and Commuter Benefits.
• Company Paid Life Insurance and Disability Coverage.
• 403 (b) + employer matching and discretionary company contributions.
• College Savings Plan.
• Ongoing training and continuous opportunities for professional growth and development.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level