Manager of Payer Contract Modeling

Deaconess Health System • Evansville, IN

3d

About The Position

The Manager of Payer Contract Modeling is a critical leadership role within the Managed Care Team at Deaconess Health System. This position oversees the development, implementation, and maintenance of complex reimbursement models used to evaluate payer contracts, forecast financial performance, and support negotiation strategies. The Manager will lead a team responsible for analyzing reimbursement methodologies, modeling contract terms, validating payment accuracy, and generating insights that advance the financial and strategic interests of the organization. This role partners closely with Managed Care leadership, Finance, Revenue Cycle, Decision Support, and Clinical Operations to ensure payer arrangements are aligned with organizational goals and support sustainable growth.

Requirements

• Experience in contract modeling and reimbursement analytics.
• Experience leading a team of analysts.
• Proficiency with contract modeling software and reimbursement tools (e.g., Strata, Epic, or similar platforms).
• Understanding of fee-for-service, value-based, bundled, and risk-based payment methodologies.
• Ability to analyze payer performance, reimbursement trends, and utilization patterns.
• Skill in modeling financial impacts of contract changes and new reimbursement structures.
• Ability to validate payment accuracy and identify underpayments or variances.
• Strong collaboration and communication skills to partner with various departments.
• Knowledge of industry best practices in contract modeling.

Responsibilities

• Lead the design, maintenance, and enhancement of contract modeling tools to evaluate fee‑for‑service, value‑based, bundled, and risk‑based payment methodologies.
• Analyze payer performance, reimbursement trends, and utilization patterns to support negotiation strategies and organizational decision‑making.
• Model financial impacts of proposed contract changes, new reimbursement structures, and emerging payment models.
• Validate payer payment accuracy and identify underpayments or variances relative to contracted terms.
• Supervise, mentor, and develop a team of analysts responsible for contract modeling and reimbursement analytics.
• Establish team priorities, allocate resources, and ensure delivery of accurate, timely analyses.
• Promote a culture of analytical rigor, operational excellence, and continuous improvement.
• Partner with Managed Care contracting leadership to prepare for negotiations and evaluate counterproposals.
• Collaborate with Revenue Cycle to interpret contract language, payment methodologies, and root causes of variances.
• Coordinate with Finance and Decision Support to integrate modeling outputs into budget forecasts, pro formas, and financial reporting.
• Oversee the configuration and optimization of contract modeling software and reimbursement tools (e.g., Strata, Epic, or similar platforms).
• Ensure modeling methodologies are transparent, auditable, and aligned with industry best practices.
• Improve workflows, documentation, and analytical standards to elevate team performance.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed