Senior Contracting Analyst
About The Position
Mount Sinai Health Partners (MSHP) is driving a transformation to a business model focused on population health management. MSHP is a fast-growing business unit within Mount Sinai, comprising over 400 employees with diverse expertise. We are seeking team members who are adaptable, comfortable with ambiguity, thrive in fast-paced environments, and are motivated to improve the status quo. The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation, and contract compliance of Facility Contracts for Commercial, Medicare Advantage, and Medicaid Managed Care Plans. This team acts as MSHP’s subject matter experts on Facility Agreements, financial performance of contracts, and negotiation of facility and ancillary contracts. The team is at the forefront of implementing Facility and Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a Senior Contracting Analyst to analyze and report on the financial performance of Commercial and Medicare Contracts with Mount Sinai. This role involves analyzing medical and pharmacy trends, researching facility amendments, procuring financial data for facility models, and reconciling financial data. The Senior Contracting Analyst will also coordinate with other departments within Mount Sinai Health Partners.
Requirements
- HS/GED; Bachelors strongly preferred. Additional experience needed in addition to “experience requirements” listed below in lieu of education.
- At least seven years of experience in healthcare analytics required (with a Bachelors degree).
- Understanding of Excel functions such as VLOOKUP, Pivot Tables, and SUMIFS required.
- Basic understanding of statistical concepts such as per capita, weighted averages, variances, and forecasting required.
Nice To Haves
- Health plan experience in Medical Economics or Value Based Payments preferred.
- Experience analyzing Facility, Professional and Pharmacy cost trends preferred.
- Familiarity with amendments between payers and providers preferred.
- Firm understanding of Facility, Professional and Pharmacy claim reimbursement preferred.
- Oral presentation experience, especially with senior management, preferred.
- Understanding of data and financial reconciliation preferred.
Responsibilities
- Research from the original contract amendments all financial terms.
- Procure and upload all financial data into Experian Contract Manager Tool to determine financial performance.
- Model Payer Proposals in Experian Contract Manager Tool.
- Reconcile budgeted revenue vs actual revenue collected.
- Perform Root Cause Analysis on medical and pharmacy trends for all contracts.
- Create Power Point Presentations detailing any analysis regarding facility contracting performance.
- Collaborate and liaise with other departments such as Commercialization, Finance, and Patient Accounts.
- Responsible for overall management and delivery of the business plan.
- Financial analysis and creation of reports as requested by department administrator or chairman as applicable.
- Compiles productivity, compliance and profit/loss reports.
- Analyzes revenues to identify collection problems, billing issues and other trends.
- May be well versed and take a proactive role in the revenue cycle, which includes all administrative and clinical functions that contribute to the capture, management and collection of patient service revenue, including overseeing those who may counsel patients on how best to meet their financial obligations.
- Reviews processes and makes recommendations to implement effective changes in procedures and policies.
- Assists with or leads special projects and provides analytical support.
- Performs other related duties.
Benefits
- Opportunity for advancement within MSHP team
- Opportunity to work directly with senior leaders from across the Mount Sinai Health System and external organizations
- Opportunity for mentorship from senior MSHP leaders
- Opportunity to be part of a forward-thinking team driving a system-wide transformation
- Opportunity to work at the forefront of innovation in healthcare
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What This Job Offers
Job Type
Full-time
Career Level
Senior
