Senior Contract Analyst - REMOTE

Vanderbilt University Medical CenterNashville, TN
Remote

About The Position

Under the strategic direction of the Manager of Payer Analytics, the Senior Analyst of Payer Analytics will drive payer contracting strategy by performing in-depth contract analytic design, execution, and interpretation. This involves deep dive analytics into payer performance and proposed contract terms to order to make decisions on how to structure payer contracts. This position will participate in the design and interpretation of standard reporting as well as conducting ad-hoc drilldowns for specific business issues. There will be interaction with CEOs and executives across three hospital sites as well as revenue cycle, payer relations, and other leadership teams.

Requirements

  • Minimum of bachelor’s degree in Business, Healthcare, Computer Science or related field.
  • 3 or more years’ experience in a managed care/healthcare environment with exposure to contract management and program development
  • EPIC experience
  • EPIC Hospital and Professional contract certification
  • Technical ability in ETL and visualization tools such as Tableau, PowerBI, and SQL
  • Knowledge of claims processing systems and guidelines
  • Experience with reimbursement methodologies for Medicare and commercial insurance; and regulatory requirements concerning payer contracts
  • Ability to produce analytics that are well-documented and easy to follow
  • Analytical skills with the ability to collect, organize, analyze, and disseminate information with attention to detail and accuracy
  • Strong written and verbal presentation skills including the ability to translate information to a variety of audiences
  • Ability to build strong relationships with internal and external stakeholders
  • Ability to be flexible and adapt in order to achieve initiative and organizational goals
  • 5 years relevant work experience

Nice To Haves

  • Master’s degree in Business Administration or comparable field of study preferred.

Responsibilities

  • Work with payer relations team on analytic design, execution, and interpretation.
  • Deliver and present analytics and interpretation to business leaders in a digestible format.
  • Provide perspective on new analytics to support payer reimbursement and performance.
  • Proactively take steps towards automation or use of new technology.
  • Provide thoughtful perspective in meetings with management.
  • Understand Medicare and commercial reimbursement, policies, and regulatory requirements and apply to contract modeling, insights, and new ideas.
  • Manage customer expectations and relationships and maintain alignment of deliverables with organization analytic needs.
  • Serve as an expert on payer contract financial terms and financial modeling.
  • Design and interpret analytics, lead training, and respond to questions across multiple departments.
  • Load, update, and maintain contracts in collaboration with a vendor.
  • Develop and maintain workflows and management processes to ensure there are no errors in contract modeling or loading.
  • Model the effect of fee schedule updates on revenue and percentage of Medicare.
  • Identify, interpret, and make recommendations regarding unclear contract or proposed contract terms.
  • For both payer contract negotiations and monitoring, discuss business needs with customer and influence the design of an analysis and execute based on jointly designed specifications.
  • Analyze data to work with colleagues to generate business insights and roll up data into a digestible format.
  • Work with manager to efficiently merge data from multiple databases and find efficient ways to complete reporting.

Benefits

  • health
  • disability
  • retirement
  • wellness offerings
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