Senior Analyst – Medical Economics and Reimbursement: CORP – Mgd Care Contracting
Senior Analyst – Medical Economics and Reimbursement: CORP – Mgd Care Contracting
About This Job
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Summary:
The Medical Economics Analyst will be responsible for supporting strategic and operational initiatives through healthcare data analytics and financial modeling for the managed care department. The Medical Economics Analyst is responsible for collecting , analyzing and interpreting healthcare data information to solve business problems.
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Detailed responsibilities:
• Perform strategic pricing analysis to support the negotiations and implementation of appropriate reimbursement rates for managed care contracting initiatives. This includes modeling of contract proposals, reporting of contract proposal impact, performance and quantifying financial impact of these proposals for future year(s) and developing alternative proposals within the budget parameters. The role will also provide pricing recommendations to optimize reimbursement.
• Develop complex analytics for value based agreements. This includes financial and quality performance metrics, identify opportunities and propose changes to the reimbursement models and risk arrangements. This includes ACO/shared savings, bundle payments, transplant and other risk arrangements.
• Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by the negotiators including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes. Analyze terms of new and existing risk and non-risk contracts and/or amendments/modifications using approved model contract language.
• Prepare complex service line reimbursement analysis and financial performance analysis using a broad spectrum of healthcare data. Develop methods and models (involving multiple variables and assumptions) to identify the implications of a wide variety of new/revised strategies, approaches, provisions, and rate structures aimed at establishing appropriate reimbursement levels.
• Key stakeholder in multiple high profile cross functional pricing, strategic or operational projects. This role provides both healthcare analytical support and subject matter expertise as it relates to the managed care book of business.
• Manages the detailed analysis, design, coding, testing, implementation and maintenance of reports, dashboards, and other delivery methods used to support managed care business analytics.
• Responsible for managing and maintaining contract pricing software for contract modeling and accounts receivable pricing. This includes fee schedule updates, architecture updates, testing and validation to ensure accurate pricing/posting of contractual allowances.
• Stay up-to-date of changing healthcare landscape to maintain an awareness of competitor services and reimbursement models, as well as opportunities for improvement of the financial components of managed care contracts.
Experience & Requirements
Working Conditions
About Memorial Healthcare System
Disclaimer
Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.
Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.
Employment is subject to post offer, pre-placement assessment, including drug testing.
If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net
Job Details
Job Category:
Clerical
Facility:
Memorial Healthcare System
Department:
Memorial Healthcare System
Job ID:
39519
Location:
Hollywood, FL
Work Shift:
FT DAYS-8
Shift Hours:
8:30 to 5:00
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Memorial Healthcare System • 3501 Johnson Street • Hollywood, FL 33021
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