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 opportunitiesApply Now

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