Sr Manager Government Analytics

Nicklaus Children's•Miami, FL

About The Position

The Sr. Manager Governmental Analytics leads Nicklaus Children's financial preparation, modeling, and forecasting related to Medicaid funding and provides analytics support for payer strategy initiatives. The role delivers analytics and trending reports for Ensemble Revenue Cycle teams, including Patient Access, Utilization Management, and underpayments related to payer issues. It supports the VP of Population Health/Payer Strategy on governmental strategic initiatives across Nicklaus Children's South, North, and future regional expansion, as well as Epic and FinThrive work and future Epic contract modeling. The role develops complex financial analytics packages and models for negotiations and other initiatives, serves as a Medicaid and legislative-session financial expert for health-system senior leadership, and works with statewide children's hospital CFOs and Government Relations leadership. It leads analysis of Medicaid and commercial proposals, supports contract negotiations, develops automated reporting, researches governmental policies and regulations, and provides analytics planning and recommendations for managed care agreements. The position also represents Nicklaus in the Directed Payment Program and manages a payer data cube for detailed financial analysis.

Requirements

Bachelor's degree in Business Administration, Healthcare Administration, or a related field.
7–10 years of experience in analytics, forecasting, and executive presentations related to Medicaid financing or reimbursement.
Experience serving on a core leadership team responsible for complex managed care payer negotiations on behalf of hospitals and physician groups.
Extensive experience using Business Intelligence systems.
Advanced Excel modeling, formulas, and automation skills.
Ability to manipulate large datasets and convert them into useful information for strategic requests.
Excellent verbal and written communication and listening skills.
Ability to maintain confidentiality of sensitive information.
Ability to problem-solve, formulate action plans, and follow through on tasks.
Ability to analyze and audit contracts, assess the overall context, and identify areas for modeling financial impact.
Ability to multitask and adapt to changing priorities.
Knowledge of reimbursement terminology, contract testing, and government and non-government payer reimbursement methodologies.
Competency in financial and statistical reporting, spreadsheet design and preparation, and other financial reports.
Skills in complex mathematical and statistical techniques.
Demonstrated leadership, development, and management of direct reports, with a focus on continuous growth.
Understanding of end-to-end revenue cycle integration with managed care.
Ability to grasp new concepts, respond effectively and promptly to changing priorities, and maintain a commitment to excellence.
Open and adaptable to constructive criticism.

Nice To Haves

Master's degree in Business, Healthcare Administration, or a related field.
Experience with FinThrive (formerly MedAssets) or a similar contract management tool system.

Responsibilities

Lead complex Medicaid and commercial analytics, evaluate financial impacts, and make recommendations.
Support contract negotiations with financial analysis connecting multidisciplinary concepts affecting reimbursement.
Create, maintain, and implement automated reporting to manage Medicaid, managed care, and value-based business, including proactive trending and impact reporting.
Research governmental regulations and policies and communicate their financial and clinical operational impacts.
Work with senior leadership on legislative priorities and complex financial models.
Monitor AHCA initiatives affecting children's hospital funding and reimbursement.
Work cross-functionally to implement required systems and organizational changes.
Apply knowledge of healthcare value transformation to the organization's foundational pillars and daily work.
Represent Nicklaus in the Directed Payment Program; develop program playbooks and collaborate with strategy consultants and statewide and regional stakeholders.
Create and manage a payer data cube for in-depth financial analysis across multiple levels and data slices.
Plan and provide analytics support and recommendations to the VP of Population Health/Payer Strategy for NCPS managed care agreements.
Lead analysis of NCPS managed care agreements involving MPIP and other Medicaid reimbursement structures.
Provide analytics and trending reports for Ensemble Revenue Cycle teams, including Patient Access, Utilization Management, and underpayments related to payer issues.
Support governmental strategic initiatives across Nicklaus Children's South, North, and future regional expansion.
Support Epic and FinThrive activities and future transition to Epic contract modeling.
Develop financial analytics packages and models for negotiations and other initiatives.
Serve as a Medicaid and legislative-session financial expert for senior health-system leadership, statewide children's hospital CFOs, and Government Relations leadership.
Develop innovative analytics for governmental, commercial, and value-based payment initiatives.