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WVU Medicine · 1 month ago

Senior Analyst Payment Modeling and Analysis, Value-Based Care - Hybrid

Morgantown, WV

Full-time

Hybrid

Mid, Senior Level

2+ years exp

WVU Medicine is a healthcare provider that is excited to offer an opportunity for a Senior Analyst Payment Modeling and Analysis in Value-Based Care. The role focuses on utilizing healthcare claim data to support Payer Relations and Contracting staff with analysis and recommendations for contract negotiations and decision-making processes.

Health CareHospitalMedical

Responsibilities

In coordination with department staff, extracts data from various internal and external sources and conducts analysis of revenue for all third party payer contracts and monitor existing effective payment percentages, in addition to modeling

Identifies data uses and develop analysis opportunities that are currently not used

Performs data analysis and creates queries, programs and automation related changes in payer contracts or other programs affecting payment

Manages Price Transparency machine readable files to comply with CMS regulation

Develop and maintain rate monitoring tools for different service lines across WVUHS

Provide support and create complex presentations, database and spreadsheets utilizing skills with various programs such as Excel, Access and PowerPoint on the PC

Leads data requirements gathering for problem identification, resolution, and solution design

Provides analytical insights from data to drive strategic business decisions

Acts as a liaison to key internal departments regarding professional and hospital contract rate updates

Analyze data from various sources and systems in order to present reports to key management and staff and to recommend and implement solutions to assist in the contracting decision-making process

Manages workload and balances quality of work with deadlines to fulfill user expectations and project goals

Develop and maintains databases to track incentive-based reimbursement. Ensures data integrity and accuracy

Communicates to all parties the natures, significance and risk factors of corresponding projects

Participates in post implementation review of projects

Gathers customer requirements to understand business needs and translate into actionable solutions

Team Building- Participates in training and professional development sessions

Offers assistance and support to co-workers

Contributes to building positive team spirit and cohesiveness

Balances team and individual responsibilities

Works proactively and cooperatively in group problem-solving situations

Qualification

Data analysisFinancial analyticsHealthcare managementMicrosoft ExcelDatabase managementPresentation skillsTeam collaborationProblem-solvingConfidentiality

Required

Bachelor's degree in finance, accounting, economics, general business management, information technology/computer science, engineering, or health care management

Two (2) years of experience in data or financial analytics

Ability to handle and maintain confidential information

Ability to work well under high stress conditions

Ability to work independently or cooperatively as a team member

Ability to adapt to various workloads and assignments

Ability to work with multi-disciplinary groups and facilitate meetings

Basic understanding of terminology involved with healthcare insurance and healthcare analysis

Solid knowledge and capable in computer use, including strong capabilities in ALL Microsoft Professional Office programs including Outlook, Word, Excel, Access, and PowerPoint

Ability to prioritize tasks

Must have independent decision-making ability

Ability to work in a fast paced and rapidly changing environment

Must be flexible

Preferred

Master's Degree in finance, business management, accounting economics, or public/health administration

Comprehensive understanding of physician groups and hospitals

Experience in health care management, related contracting field, health care insurance services/industry, hospital finance and/or healthcare consulting