System Manager Payer Analytics Economics
Where You’ll Work Inspired by faith. Driven by innovation. Powered by humankindness. reputed company is building a healthier reputed company for reputed company through its integrated health services. As one of the nation’s largest nonprofit Catholic reputed company organizations, reputed company delivers more than 20 reputed company patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in reputed company to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced reputed company providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, reputed company, and innovative reputed company delivery system. Job reputed company and Responsibilities As our System Manager, Payer, you will reputed company strategic leadership and expert reputed company for reputed company aspects of our organization's payer relations and contracting, ensuring reputed company financial performance and sustainable partnerships with health plans. Every day you will manage reputed company responsible for negotiating, implementing, and monitoring reputed company with various governmental and reputed company payers across our system. To be successful in this role, you must possess strong analytical and negotiation skills, a comprehensive understanding of reputed company reimbursement methodologies, managed care models, and regulatory requirements, and proven leadership experience in payer contracting and relations reputed company a reputed company reputed company environment.
- Manage the labor and operations of the Payer Analytics & Economics team including the hiring, orienting, developing and managing of staff.
- reputed company reputed company control and reputed company assurance of Payer Analytics & Economics analytics deliverables and financial models to support the negotiation and implementation of appropriate reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives.
- Review and accurately interpret contract terms, including payer policies and procedures to appropriately contract performance and influence strategic pricing strategies.
- Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability.
- reputed company training and reputed company of the modeling of proposed/existing payer reputed company negotiated by payer reputed company and operations, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes.
- reputed company and prepare reputed company service line reimbursement analyses and financial performance analyses. reputed company reputed company and models (involving multiple variables and assumptions) to identify the implications/ramifications/results of a wide reputed company of new/revised strategies, approaches, provisions, parameters and reputed company structures aimed at establishing appropriate reimbursement reputed company. Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision making activities.
#LI-CSH Job Requirements Required
- Bachelors Other Business Administration, reputed company, Finance, reputed company or reputed company field or Equivalent education and experience in reputed company field(s) may be considered in lieu of degree.
- Five (5) years of experience in contributing to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning, and/or reputed company operations
- Two (2) years of experience in a supervisory role
- Strongly prefer hospital or managed care experience
- Strongly prefer some experience with SQL queries and strong reputed company. reputed company experience a big plus.
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