Sr Payer Analyst / Managed Care Contracting

Hartford HealthCare • Hartford, CT

89d

About The Position

Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer Analyst is responsible for payer contracting analytics with a focus on hospital and ancillary. Reviews and monitors contract/payer performance including payer parity. Compares expected reimbursement data to cost performance by service line. Responsible for maintaining payment related tools such as payer rate grids. Responsible for maintaining accurate expected reimbursement build in the EPIC system. Responsible for overseeing ad hoc analysis in support of various HHC and ICP contracting.

Requirements

• Minimum: BA/BS degree.
• Minimum: 5 years of hospital and physician contract modeling experience.
• Advanced knowledge/expertise regarding current and evolving provider payment methodologies with a focus on hospital and physician.
• Knowledge of governmental payment structures.
• Advanced expertise and experience with contract modeling software as well as other financial software including hospital information systems and reporting tools (EPIC).
• Experience working with large data sets.
• Advanced Excel ability required.
• Demonstrated expertise on billing and coding is required as well as broad knowledge of health care finance and accounting issues.

Nice To Haves

• Preferred: BA/BS degree in Health Care, MIS, Finance, Statistics or Mathematics.
• Preferred: 5+ years of hospital and ancillary contract modeling experience.
• Preferred: Epic certification.
• Tableau/SQL experience a plus.
• Knowledge of cost accounting and EPSi highly desired.
• Strong interpersonal and communication skills essential as well as demonstrated ability to work collaboratively across functional areas.
• Superior analytic and problem solving skills.
• Customer service focus.

Responsibilities

• Develop analysis in support of payer contracting efforts, including review of cost performance.
• Maintain accurate expected reimbursement build in the EPIC system.
• Maintain payment related tools such as payer rate grids.
• Maintain a process for final modeling information review.
• Work collaboratively with revenue cycle, medical records/coding and compliance to identify and correct issues.
• Develop ad hoc analysis in support of HHC and/or ICP contracting initiatives.

Benefits

• Competitive benefits program designed to ensure work/life balance.

What This Job Offers

• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees