Analyst, Payer Relations
Job Description:
• Collect and validate data from hospitals for modeling, analytics, and presentation.
• Evaluate existing and proposed payer contracts to determine financial feasibility and impact on the organization’s bottom line.
• Model Portal – Maintain all request for all hospital models and maintain tracker
• Analyze and interpret complex managed care contract proposals, including reimbursement methodologies, and load or update contract terms in the designated contract management system.
• Manage data validation for all databases.
• Audit and monitor claim payments from managed care plans to ensure accurate reimbursement according to contract terms.
• Investigate payment variances and discrepancies, identifying root causes for underpayments.
• Assist with data analysis and create tables and forms for Presentation.
• Monitor and manage assigned deadlines for models. Including tracker maintenance and internal communication with consultants
• Assist with regular/ad hoc reporting requests, dashboards for management on payer mix, financial performance, and compliance metrics.
• Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems.
• Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations.
• Graphically/analytically strong; excellent analytical, critical thinking, and problem-solving skills, with meticulous attention to detail.
• Strong communication skills to effectively present complex data to both technical and non-technical stakeholders.
• Track and report on Key Performance Indicators (KPIs)
• Assist with validating financial analysis prior to presenting to hospital or payers
• Maintain and organize client information
• Assist leadership with annual team goals
Requirements:
• Minimal travel
• Understanding of managed care contracting and related initiatives are useful but not required as well as the underlying systems that support those initiatives.
• Understanding of Revenue Cycle process is useful but not required.
• BS Preferred
• Advanced knowledge of Microsoft products Excel (VLOOKUPS, Pivot tables, data modeling)
• Familiar with Microsoft Power Point / Power BI
• Experience with Electronic Health Records (EHR) and Billing Systems (i.e. Epic, Cerner) preferred
• Ability to interact with clients and strong communication skills
• Team player
• Organizational skills / multitasking
• Data analysis experience critical
• Critical thinker
• Problem solving skills
• Ability to work in a fast-paced environment independently
Benefits:
• Health insurance
• Professional development opportunities
Apply Now
Apply Now
• Collect and validate data from hospitals for modeling, analytics, and presentation.
• Evaluate existing and proposed payer contracts to determine financial feasibility and impact on the organization’s bottom line.
• Model Portal – Maintain all request for all hospital models and maintain tracker
• Analyze and interpret complex managed care contract proposals, including reimbursement methodologies, and load or update contract terms in the designated contract management system.
• Manage data validation for all databases.
• Audit and monitor claim payments from managed care plans to ensure accurate reimbursement according to contract terms.
• Investigate payment variances and discrepancies, identifying root causes for underpayments.
• Assist with data analysis and create tables and forms for Presentation.
• Monitor and manage assigned deadlines for models. Including tracker maintenance and internal communication with consultants
• Assist with regular/ad hoc reporting requests, dashboards for management on payer mix, financial performance, and compliance metrics.
• Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems.
• Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations.
• Graphically/analytically strong; excellent analytical, critical thinking, and problem-solving skills, with meticulous attention to detail.
• Strong communication skills to effectively present complex data to both technical and non-technical stakeholders.
• Track and report on Key Performance Indicators (KPIs)
• Assist with validating financial analysis prior to presenting to hospital or payers
• Maintain and organize client information
• Assist leadership with annual team goals
Requirements:
• Minimal travel
• Understanding of managed care contracting and related initiatives are useful but not required as well as the underlying systems that support those initiatives.
• Understanding of Revenue Cycle process is useful but not required.
• BS Preferred
• Advanced knowledge of Microsoft products Excel (VLOOKUPS, Pivot tables, data modeling)
• Familiar with Microsoft Power Point / Power BI
• Experience with Electronic Health Records (EHR) and Billing Systems (i.e. Epic, Cerner) preferred
• Ability to interact with clients and strong communication skills
• Team player
• Organizational skills / multitasking
• Data analysis experience critical
• Critical thinker
• Problem solving skills
• Ability to work in a fast-paced environment independently
Benefits:
• Health insurance
• Professional development opportunities
Apply Now
Apply Now