Payer Contracting Manager - Payer Rate Development and Payer Performance Reporting

Intermountain Health • Dayton, OH

1d • $56 - $89 • Remote

About The Position

The Payer Contracting Manager of Payer Rate Development and Payer Performance Reporting produces analytical solutions (modeling, reports, dashboards, tools, etc.) for leadership and stakeholders across the organization that supports business or clinical initiatives. In addition, the manager provides consultation and support in the development, analysis, interpretation, and management of a variety of highly complex data sources to support process improvement, operations, revenue growth and integrity, strategy, cost reduction, and increased patient safety and satisfaction. Along with offering a chance to work in a stable, strong, mission-based environment, this role provides the opportunity to experience the Mountain West’s diverse culture and incredible landscapes. You’ll be able to explore abundant outdoor recreational opportunities, including skiing, hiking, and fishing, as well as stunning national parks and forests, all within hours of where you’ll call home. Becoming a part of the Intermountain team means gaining a family and finding a place to plant your roots.

Requirements

• Bachelor’s Degree with five years of analytics experience.
• Demonstrated proficiency and an advanced working knowledge of MS Excel, Strata, Epic, and other tools, applying quality improvement principles, and a solid knowledge of database design principles.
• Demonstrated experience in developing, analyzing, interpreting, and managing a variety of complex data sets.
• Demonstrated capabilities in planning, participating, and managing a variety of complex analytics projects to meet required timelines.
• Solid experience using industry standard BI, statistical, or analytical tools and technologies.
• Epic Resolute Billing Expected Reimbursement Contracts Administration certification with a recommended three years experience.
• Five years of experience in a role requiring management of projects and accountabilities from inception to conclusion in an effective and comprehensive manner that appropriately evaluates implications and results in solid solutions, securing beneficial results that add value and contribute to strategic direction.
• Five years of experience with revenue cycle, patient accounting, third party payer contracting and/or payer contract modeling system including knowledge of value-based contract payment structures and payment mechanisms.
• Demonstrated strong proficiency using word processing, spreadsheet, database, internet and e-mail, and scheduling applications.
• Demonstrated effective verbal and written communication skills which allow candidate to present advanced topics in a clear, concise, polished and professional manner.
• Demonstrated experience working efficiently and effectively with skilled professionals.
• Willingness to flex work schedule to meet required deadlines.
• Must live in the State of Utah.

Nice To Haves

• Master's Degree in an analytics-related field such as statistics, mathematics, information systems, computer science, finance, economics, or an MBA with an emphasis in analytics.
• If degree is not in an analytics related field five years of analytics experience demonstrating proficiency performing the job essentials at this job level.
• Demonstrated proficiency and an advanced working knowledge of SQL (structured query language).
• Interpersonal skills - interacts effectively with individuals both inside and outside of organization; relates openly and comfortably with diverse groups of people.
• Five years of Epic contract build, billing and revenue cycle experience.
• Knowledge of State and CMS program payment methodologies and regulations.

Responsibilities

• Lead payer payment modeling using Epic and other related tools for all Intermountain Health regions, applying data and ad hoc scenarios to detailed payment methodologies, historical data and projected changes.
• Be accountable for timely and accurate reports as requested by leadership and stakeholders across the organization that support business and clinical initiatives.
• Create payer performance reports that answer multiple related questions as well as reports with linked content, drilldown, and nested parameters, formatted in an organized, easy-to-understand fashion.
• Use standard Intermountain reporting tools to generate reports for end users that interpret data for others to promote evidence-based decision making.
• Compare data output to ensure data accuracy and create basic QA test plans and validates data for accuracy.
• Responsible for documenting work / projects per enterprise-wide standards (reports, project tracking, databases, etc.).
• Support contract negotiations and contract implementation by being a content expert for payer contract rates and methodologies, and developing new payment models.
• Support Payer Contracting in writing and reviewing contract language, supporting the process for Epic contract builds, and making recommendations as appropriate to department management.
• Oversee and coordinate the communication and messaging to internal parties of new contract rates and terms, rate structure and payment methodologies to ensure alignment and accurate programming of contract builds.
• Provide project management / project leadership as appropriate to drive timelines and deliverables.
• Supervise supporting contract analysts.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Healthy Living program (financial incentives, digital tools, tobacco cessation, classes, counseling, paid time off)
• Financial wellness tools
• Retirement planning
• Annual pay-for-performance opportunity (“AP4P”)
• Up-front tuition coverage paid directly to the academic institution through the PEAK program (100+ learning options including undergraduate studies, high school diplomas, and professional skills and certificates, eligible on day 1 of employment).

What This Job Offers

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