System Manager Payer Analytics Economics

• Provide strategic leadership and expert oversight for all aspects of our organization's payer relations and contracting
• Manage a team responsible for negotiating, implementing, and monitoring contracts with various governmental and commercial payers across our system
• Manage the labor and operations of the Payer Analytics & Economics team including the hiring, orienting, developing and managing of staff
• Oversee quality control and quality 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
• 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
• Oversee and 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, provisions, parameters and rate structures aimed at establishing appropriate reimbursement levels. Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision making activities.

• Bachelors Other Business Administration, Accounting, Finance, Healthcare or related field or Equivalent education and experience in related 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 healthcare 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 Excel. EPIC experience a big plus.

• Hospital or managed care experience
• Experience with SQL queries and strong Excel
• EPIC experience

Medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings