Senior Payer Contract Analyst (Full-Time/Day) Hybrid
Jefferson Health Plans•Philadelphia, PA
•Hybrid
About The Position
The Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess the impact of industry trends and government regulations. This role involves retrieving, aggregating, and analyzing data from multiple sources using various tools to support the Payer Contracting department. The analyst will collaborate with team members to understand their needs and goals, acting as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.
Requirements
- Bachelor’s Degree in Finance, Healthcare Administration, Business, or related field.
- 5 years of experience in payer-related positions within the provider or insurance industry.
- Minimum 5 years of experience in budgeting, insurance/payer-related financial analysis, net revenue reimbursement modeling and performance computations, decision support, and general financial reporting.
- Intermediate to advanced capabilities with Microsoft Excel and PowerPoint.
- Experience building and manipulating Contract Modeling tools and BI/Data Analytics applications (e.g., Qlik, Tableau, Microsoft PowerBI, EPSi).
- Ability to thrive in a fast-paced, agile work environment with high expectations and accountability.
- Excellent written and verbal communication skills.
- Efficient conceptualization, analytical, and logic skills.
Nice To Haves
- Master’s Degree in Finance, Healthcare Administration, Business, or related field.
Responsibilities
- Conduct detailed managed care contract modeling and analysis using available contract modeling systems.
- Build flexible models that aggregate fee-for-service and value-based data from multiple sources and enable scenario play.
- Maintain key department metrics (e.g., Managed Care Financial Reporting package, payer mix, reimbursement benchmarks) and monitoring tools (e.g., contract and rate tracking grids).
- Ensure compliance with all CMS Price Transparency requirements relating to the development, accuracy, and publication of machine-readable files.
- Monitor payer policy updates and quantify the impact of potential material harm and/or other contract implications.
- Validate payer rate loads to ensure contracts are being executed accurately and perform root-cause analysis of variances.
- Serve as a resource to management to assist in ad-hoc projects.
Benefits
- Medical (including prescription)
- Supplemental insurance
- Dental
- Vision
- Life and AD&D insurance
- Short- and long-term disability
- Flexible spending accounts
- Retirement plans
- Tuition assistance
- Voluntary benefits
- Tuition discounts at Thomas Jefferson University (after one year of full-time service or two years of part-time service)
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What This Job Offers
Job Type
Full-time
Career Level
Senior
