Senior Financial Analyst, Managed Care

Hiring Ritual • Brentwood, TN

3d • Onsite

About The Position

The Sr. Financial Analyst, Managed Care, drives analytics and decision support in assigned regions by translating real world payer contract rates, terms, volume, utilization trends, and network development challenges into actionable insights to assist in the strategic positioning of revenue, payer contracts, and overall network strategy. The Sr. Financial Analyst works closely with Managed Care leaders to prioritize needs of assigned regions and ensure provision of timely and accurate deliverables.

Requirements

• Bachelor's Degree in (Business, Mathematics, Engineering, Finance, Information Systems, or other quantitative field of study)
• 3+ years of experience
• Mathematical Skills
• Business Mathematical Skills -- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rates, ratios, and percentages and to draw and in-interpret graphs.
• Computer Skills
• Technical Computer Skills -- Demonstrate use of intermediate computer operations (basic programming, relation-al databases, and operating systems) and intermediate software packages.
• Communication
• Moderate Communication -- Regularly uses moderately complex oral and written skills. May train others in functional areas, interact with others and make presentations to department or middle management.
• Decision Making
• Department Specific Impact -- Decisions impact the management and operations within a department. May con-tribute to business and operational decisions that affect the department.
• Nature of Problems
• Varied Business Problems -- Problems are varied and complex, requiring analysis or interpretation of the situation. Problems are solved using knowledge and skills, general precedents and practices.
• Independent Judgement
• Moderate Independent Judgement -- Results are defined; sets personal own goals and determines how to achieve results with few or no guidelines to follow; supervisor/manager provides broad guidance and overall direction.
• Planning/Organization
• Project Management -- Handle multiple projects simultaneously including task delegation, project oversight, and resource allocation.
• Exhibit an understanding of healthcare regulatory and compliance (e.g., HIPAA).
• Skilled in the application of policies and procedures.
• Knowledge of Business Office Standards and Recommended Practices.

Nice To Haves

• Six Sigma Certification

Responsibilities

• Model hospital, physician, and ancillary payer contracts using Excel and/or other managed care modeling tools to quantity contractual value and changes in contractual value.
• Collaborate with Managed Care leaders to report the financial impact of changes in fee-for-service and value-based contract rates and terms to allow the team to make informed decisions during negotiations with insurance payers.
• Understand and translate complex contracts and payment methodologies.
• Utilize various and several Business Intelligence (BI) tools to gather, manipulate, and analyze data to provide insight into payer contract performance.
• Summarize reimbursement by payor, facility, insurance plan, etc., to analyze underpayments or other various payment scenarios.
• Design, develop, and deliver ad hoc reporting and analysis, including payer policy quantitative and qualitative impact analysis, service line volume trends, litigation support, charge master optimization, and other analysis as needed.
• Update standard managed care and revenue cycle reports per their reporting schedule or as needed.
• Build reporting models requiring an understanding of business processes, reporting needs, and a complex information system.
• Assist with training and mentoring of other analytic staff.
• Review and abstract contract term language that significantly impacts hospital reimbursement.
• Coordinate with managed care negotiators to identify all updates to managed care contracts.
• Distribute new and updated managed care contracts to impacted stakeholders (internal and external).
• Research and locate missing information related to managed care contracts.
• Regular and reliable attendance.
• Perform other duties as assigned.

Benefits

• Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status or any other basis protected by applicable federal, state or local law.

What This Job Offers

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