Senior Analyst Payer Analytics and Economics jobs in United States
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CommonSpirit Health · 2 hours ago

Senior Analyst Payer Analytics and Economics

CommonSpirit Health is one of the nation’s largest nonprofit Catholic healthcare organizations, dedicated to building a healthier future through integrated health services. The Senior Analyst, Payer Analytics & Economics will perform complex financial analysis and strategic pricing for managed care payer contracts, providing mentorship and guidance while supporting stakeholders in reimbursement models.

Health CareMedicalNon Profit

Responsibilities

Lead payer contract modeling strategy and consolidation for large managed care payer negotiations
Act as a liaison between CommonSpirit Health and payer to update information and communicate changes related to reimbursement
Perform complex strategic pricing analysis to support the negotiation and implementation of appropriate reimbursement rates and associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives
Develop and approve financial models and payer performance analysis
Monitor contract financial performance
Analyze and publish managed care performance statements and determine profitability
Review and accurately interpret contract terms, including payer policies and procedures impacting contract performance
Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by payer strategy and operations, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes
Prepare complex service line reimbursement analyses and financial performance analyses
Develop methods and models (involving multiple variables and assumptions) to identify the implications/ramifications/results of a wide variety of new/revised strategies, approaches, provision, parameters and rate structures aimed at establishing appropriate reimbursement levels
Identify, collect, and manipulate from a wide variety of financial and clinical internal data bases and external sources
Identify and access appropriate data resources to support analyses and recommendations

Qualification

Financial analysisHealthcare reimbursementContract modelingData management strategiesStrategic pricing analysisMentorshipProblem-solvingCommunication

Required

Bachelors Other Bachelor's Degree in Business Administration, Accounting, Finance, Healthcare or related field. or Equivalent education and experience, in related field may be considered in lieu of degree
Three (3) years of experience in financial healthcare reimbursement analysis is required, including an understanding of national standards for fee-for-service and value-based provider reimbursement methodologies
Experience in contribution to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations

Company

CommonSpirit Health

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Common Spirit Health is a healthcare organization that provides research programs, home health programs, and virtual care services. It is a sub-organization of CommonSpirit Health.

Funding

Current Stage
Late Stage

Leadership Team

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Wright Lassiter
Chief Executive Officer
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Christine Brocato
System VP, Strategic Innovation
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Company data provided by crunchbase