Senior Manager, Managed Care Analytics - Full Time - Days - Corporate

Atlantic Health System•Morristown, NJ

19d•$75 - $131•Onsite

About The Position

The Senior Manager of Managed Care Analytics serves as the enterprise leader for payer analytics, reimbursement modeling, and data governance across the managed care contracting lifecycle. This role is the system’s chief data steward for managed care, responsible for ensuring analytical accuracy, methodological consistency, and strategic insight that directly shapes payer negotiations, revenue integrity, and long‑term financial performance. This leader oversees a team of analysts and collaborates closely with Managed Care, Finance, Revenue Cycle, Population Health, Clinical Operations, and executive leadership. The Director drives the development of advanced financial models, contract repricing engines, payer scorecards, and market intelligence tools that support both fee‑for‑service and value‑based arrangements.

Requirements

Enterprise leader for payer analytics, reimbursement modeling, and data governance
Chief data steward for managed care
Ensures analytical accuracy, methodological consistency, and strategic insight
Shapes payer negotiations, revenue integrity, and long-term financial performance
Oversees a team of analysts
Collaborates with Managed Care, Finance, Revenue Cycle, Population Health, Clinical Operations, and executive leadership
Drives development of advanced financial models, contract repricing engines, payer scorecards, and market intelligence tools
Supports fee-for-service and value-based arrangements
Subject matter expert on reimbursement methodologies (DRG, per diem, percent of charge, fee schedule, etc.)
Expert on DRG, APC, fee schedule, percent of charge, bundled payments, and emerging reimbursement methodologies
Experience with Epic tools to model contract changes, forecast reimbursement impacts, and support negotiation strategy
Experience querying, integrating, and normalizing complex datasets (hospital, professional billing, pharmacy, claims, third party sources)
Experience maintaining market intelligence tools, including competitor profiling and regional market assessments
Experience validating data extracts, troubleshooting discrepancies, and ensuring analytical accuracy
Experience building payer/program specific P&Ls and profitability analyses
Experience developing dashboards and scorecards that track fee for service and value based contract performance
Experience monitoring medical cost trends, utilization patterns, and reimbursement shifts
Experience driving automation of recurring analytics, including SQL pipelines, BI dashboards, and contract modeling workflows

Nice To Haves

Experience with IT, Finance, Revenue Cycle, and Informatics to align data sources, methodologies, and reporting infrastructure.

Responsibilities

Serve as the Managed Care department’s data steward, ensuring data accuracy
Partner with IT, Finance, Revenue Cycle, and Informatics to align data sources, methodologies, and reporting infrastructure.
Lead financial modeling and repricing analyses to support payer contract negotiations across hospital, physician, ancillary, and value based arrangements.
Analyze historical and projected payer performance, including medical cost trends, utilization patterns, yield changes, and reimbursement impacts.
Forecast financial risks and opportunities associated with managed care contracts.
Serve as the subject matter expert on reimbursement methodologies (DRG, per diem, percent of charge, fee schedule, etc.).
Oversee the creation of dashboards that track fee for service and value based contract performance
Build payer/program specific P&Ls and profitability analyses.
Query, integrate, and normalize complex datasets (hospital, professional billing, pharmacy, claims, third party sources).
Maintain market intelligence tools, including competitor profiling and regional market assessments.
Validate data extracts, troubleshoot discrepancies, and ensure analytical accuracy.
Use Epic tools to model contract changes, forecast reimbursement impacts, and support negotiation strategy.
Collaborate with the Director of Managed Care to prioritize and assign analytical work, review outputs, and ensure adherence to data governance standards.
Foster a collaborative, high-performance analytical environment.
Act as a key analytical partner to Finance, Revenue Cycle, ACO/Population Health, Clinical Operations, and other stakeholders.
Participate in interdisciplinary workgroups and system wide initiatives requiring payer analytics or reimbursement expertise.
Clearly convey complex analytical insights to leadership and diverse stakeholder groups
Serve as the system expert on DRG, APC, fee schedule, percent of charge, bundled payments, and emerging reimbursement methodologies.
Lead payer proposal evaluation, counter proposal development, and negotiation analytics.
Develop dashboards and scorecards that track payer performance, yield, denial trends, PMPM, MLR, TME, and value-based metrics.
Build payer specific P&Ls and profitability analyses.
Monitor medical cost trends, utilization patterns, and reimbursement shifts
Drive automation of recurring analytics, including SQL pipelines, BI dashboards, and contract modeling workflows

Benefits

Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
Life & AD&D Insurance.
Short-Term and Long-Term Disability (with options to supplement)
403(b) Retirement Plan: Employer match, additional non-elective contribution
PTO & Paid Sick Leave
Tuition Assistance, Advancement & Academic Advising
Parental, Adoption, Surrogacy Leave
Backup and On-Site Childcare
Well-Being Rewards
Employee Assistance Program (EAP)
Fertility Benefits, Healthy Pregnancy Program
Flexible Spending & Commuter Accounts
Pet, Home & Auto, Identity Theft and Legal Insurance