System Manager Payer Analytics Economics Job at American Nursing Care (Rancho Cordova)

System Manager Payer Analytics Economics

Provide strategic leadership and expert oversight for all aspects of our organiz...

Location

United States , Englewood

Salary:

49.78 - 70.05 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

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.

Job Responsibility

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.

What we offer

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

Fulltime

Manager, Health Economics & Outcomes Research (HEOR)

The Manager, Health Economics & Outcomes Research (HEOR) is the primary health e...

Location

United States , Deerfield

Salary:

136000.00 - 187000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

Bachelors in Health Economics, Outcomes Research, Epidemiology, or related field
5+ years of HEOR experience in MedTech, Pharma, or consulting, preferably with hospital-based products
Proven experience developing economic models (BIA, CEA)
Demonstrated experience in scientific publication development and evidence communication
Strong ability to interpret outputs from real-world data analyses (e.g., SQL, R, Python-supported workflows)
Up to 30% travel

Job Responsibility

Design and maintain economic models, including budget impact analyses (BIA) and cost-effectiveness analyses (CEA), across the surgical portfolio (e.g., Floseal, Tisseel, Coseal)
Develop frameworks to translate hospital utilization data into total cost of care, efficiency, and product optimization insights
Provide the scientific foundation to support value-based agreements and hospital contracting through economic evidence generation
Define the evidence generation strategy and identify key clinical and economic evidence gaps in the U.S. surgical market
Lead the design of retrospective real-world evidence (RWE) studies and guide analytic execution in partnership with RWD analysts
Conduct literature reviews and meta-analyses to benchmark product performance against competitive technologies
Lead development of peer-reviewed manuscripts, abstracts, and conference submissions (e.g., ISPOR, AORN, surgical congresses)
Develop and maintain compliant scientific exchange tools ("Safe Harbor" materials) for Medical Science Liaisons and field teams
Lead Medical/Legal/Regulatory (MLR) review processes to ensure all materials meet compliance requirements
Partner with Medical Affairs leadership, RWD analysts, and cross-functional teams to align evidence generation with strategic priorities

What we offer

Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP), with the ability to purchase company stock at a discount
401(k) Retirement Savings Plan (RSP), with options for employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Time-off benefits such as paid holidays, paid time off ranging from 20 to 35 days based on length of service, family and medical leaves of absence, and paid parental leave
Commuting benefits
Employee Discount Program
Employee Assistance Program (EAP)

Fulltime

Manager, Health Economics & Outcomes Research (HEOR)

The Manager, Health Economics & Outcomes Research (HEOR) is the primary health e...

Location

United States , Deerfield

Salary:

136000.00 - 187000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

Bachelors in Health Economics, Outcomes Research, Epidemiology, or related field
5+ years of HEOR experience in MedTech, Pharma, or consulting, preferably with hospital-based products
Proven experience developing economic models (BIA, CEA)
Demonstrated experience in scientific publication development and evidence communication
Strong ability to interpret outputs from real-world data analyses (e.g., SQL, R, Python-supported workflows)
Up to 30% travel

Job Responsibility

Design and maintain economic models, including budget impact analyses (BIA) and cost-effectiveness analyses (CEA), across the surgical portfolio (e.g., Floseal, Tisseel, Coseal)
Develop frameworks to translate hospital utilization data into total cost of care, efficiency, and product optimization insights
Provide the scientific foundation to support value-based agreements and hospital contracting through economic evidence generation
Define the evidence generation strategy and identify key clinical and economic evidence gaps in the U.S. surgical market
Lead the design of retrospective real-world evidence (RWE) studies and guide analytic execution in partnership with RWD analysts
Conduct literature reviews and meta-analyses to benchmark product performance against competitive technologies
Lead development of peer-reviewed manuscripts, abstracts, and conference submissions (e.g., ISPOR, AORN, surgical congresses)
Develop and maintain compliant scientific exchange tools ("Safe Harbor" materials) for Medical Science Liaisons and field teams
Lead Medical/Legal/Regulatory (MLR) review processes to ensure all materials meet compliance requirements
Partner with Medical Affairs leadership, RWD analysts, and cross-functional teams to align evidence generation with strategic priorities

What we offer

Medical and dental coverage that start on day one
Basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP) with employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Time-off benefits such as paid holidays
Paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave

Fulltime

Manager, Health Economics & Outcomes Research (HEOR)

The Manager, Health Economics & Outcomes Research (HEOR) is the primary health e...

Location

United States , Deerfield

Salary:

136000.00 - 187000.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

Bachelors in Health Economics, Outcomes Research, Epidemiology, or related field
5+ years of HEOR experience in MedTech, Pharma, or consulting, preferably with hospital-based products
Proven experience developing economic models (BIA, CEA)
Demonstrated experience in scientific publication development and evidence communication
Strong ability to interpret outputs from real-world data analyses (e.g., SQL, R, Python-supported workflows)
Up to 30% travel

Job Responsibility

Design and maintain economic models, including budget impact analyses (BIA) and cost-effectiveness analyses (CEA), across the surgical portfolio (e.g., Floseal, Tisseel, Coseal)
Develop frameworks to translate hospital utilization data into total cost of care, efficiency, and product optimization insights
Provide the scientific foundation to support value-based agreements and hospital contracting through economic evidence generation
Define the evidence generation strategy and identify key clinical and economic evidence gaps in the U.S. surgical market
Lead the design of retrospective real-world evidence (RWE) studies and guide analytic execution in partnership with RWD analysts
Conduct literature reviews and meta-analyses to benchmark product performance against competitive technologies
Lead development of peer-reviewed manuscripts, abstracts, and conference submissions (e.g., ISPOR, AORN, surgical congresses)
Develop and maintain compliant scientific exchange tools (Safe Harbor materials) for Medical Science Liaisons and field teams
Lead Medical/Legal/Regulatory (MLR) review processes to ensure all materials meet compliance requirements
Partner with Medical Affairs leadership, RWD analysts, and cross-functional teams to align evidence generation with strategic priorities

What we offer

Medical and dental coverage starting on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP) with ability to purchase company stock at a discount
401(k) Retirement Savings Plan (RSP) with options for employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Paid holidays
Paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave

Fulltime

New

Head of Global Product Strategy, Neuroscience

The VP Head of Global Product Strategy for Neuroscience is a strategic leadershi...

Location

United States , Boston

Salary:

320000.00 - 440000.00 USD / Year

BioLife Plasma Services

Expiration Date

Until further notice

Requirements

15+ years of experience within the pharmaceutical/biotech industry including line management and matrix leadership roles
Advanced degree in science or business preferred
Demonstrated track record of successful multiple country, multiple product commercialization (launch planning through life cycle management)
Deep knowledge of therapy area or the proven ability to acquire this rapidly
Strong understanding of the drug development processes and regulatory pathways, product supply issues and new product evaluation and collaborates across the organization to incorporate the needs of internal stakeholders in the commercial planning process
Thorough understanding of commercial aspects of the business including market dynamics, brand management, sales planning and execution, market access, patient advocacy, regulatory environments and reimbursement challenges across both domestic and International market
Thorough global launch experience
Strong financial acumen with the ability to assimilate complex information to design and manage budgets and meet financial targets
Established and respected leader with a track record of advancing an organization in a collaborative way
Experience leading through change and managing ambiguity, working in an area without strong boundaries

Job Responsibility

Establishes strategies and plans to ensure optimal lifecycle management of the portfolio of marketed products within the Neuroscience franchise
translates long range strategic plans into short term goals and actions with the regions
Develops the strategy and creates operational commercial plans for the franchise including key performance measurements (i.e. margins and SG&A), global brand plans and global marketing campaigns
Global market access plans developed in close collaboration with the Payer Value and Patient Access Team
Leverages enabling resources such as Insights & Analytics, Payer Value and Patient Access and others as needed
Serves as a member of the Strategy & Portfolio Development (SPD) leadership team, representing the interests of the franchise, serving as an expert on long range strategic and life cycle plans
Owns the direct collaboration with the relevant BU/TAU and other functions to guide the development of commercially viable product profiles for both in-house development assets and external business development opportunities
Manages the effective transfer of development assets into the franchise
Manages a global team and builds organizational and individual capabilities to drive the achievement of strategy including developing a bench strength of talent, evolving technologies, operating systems and business processes.

What we offer

Short-term and/or long-term incentives
medical, dental, vision insurance
401(k) plan and company match
short-term and long-term disability coverage
basic life insurance
tuition reimbursement program
paid volunteer time off
company holidays
well-being benefits
up to 80 hours of sick time

Fulltime

National Lead, Access & Public Affairs - West

The National Lead, Access and Public Affairs - West is responsible for activitie...

Location

Canada

Salary:

Not provided

The Muse

Expiration Date

Until further notice

Requirements

Bachelors degree in business, health policy, health economics, life sciences or healthcare discipline
MBA preferred
10+ years of pharmaceutical / biotech industry experience including experience in market access & stakeholders management
Demonstrated key payer relationships and accomplishments at the national and local level
Demonstrated excellence in portfolio management and project management
Successful experience in leading cross-functional teams
Have successfully demonstrated the ability to build strong relationships with high level leaders and external stakeholders
Consultative partnerships: ability to identify emerging stakeholder needs and to problem-solve in innovative ways (programs, contracts etc.) to help CSL meet those needs
In-depth knowledge of Canadian Public and Private reimbursement, HTA and formulary listings processes
Ability to work independently and take the lead role on assigned projects

Job Responsibility

Responsible for developing and implementing national strategic access plans that ensure funding of CSL's products across the country, (ii) shaping an environment that values innovative therapies and enable timely access to patients and partner with health-system stakeholders to facilitate the integration of new therapies, enhancing patient outcomes
Develop and ensure that the stakeholder engagement strategy, execution, and focus are aligned to support product market access goals, therapeutic leadership, and corporate reputation
Accountable for representing CSL Canada to collaborate with public drug programs, and other government organizations, private insurers, and key HCPs
Develop and implement strategies and plans that aim to strengthen relationships, raise disease awareness, negotiate strategic partnerships and collaborations, improve patient access that are aligned with CSL strategic objectives
Lead the development of professional relationships with key stakeholders at a product level (e.g. support input in the Health Technology Assessment process, discuss product files with drug plans, etc.), at a therapeutic leadership level (e.g. manage key national stakeholder partnership projects), and at a corporate reputation level (e.g. manage key sponsorships, key corporate communications)
Lead national and provincial negotiations and partnership agreements, ensuring mutual value creation and long-term collaboration
Identify emerging market access trend issues and lead the development of a strategic and organized approach for advocating for patient-focused solutions
Identify external challenges/opportunities and emerging issues that may impact CSL and work with team to recognize internal and external communications opportunities and solutions
Define and execute appropriate strategies to support them
Develop specific communication tools and vehicles for the appropriate dissemination of information to the patient community, drug plans, and other stakeholders

What we offer

Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Short-Term Disability
Long-Term Disability
FSA
HSA
Mental Health Benefits
Adoption Leave

Fulltime

Student Intern - Financial Analyst

The Financial Analyst Intern supports the System Finance with operational and/or...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

High school diploma or general education degree (GED), preferably currently enrolled in a school of higher education
Preferably currently pursuing a Bachelor’s degree in Finance, Accounting, Economics, Business, or a related field
None required
preferred at least six (6) months of related experience or training in area of internship
Prior internship, coursework, or academic projects involving financial analysis, accounting, or data analysis preferred
Licensure or certification: None required
Strong work ethic and willingness to learn at an accelerated pace
Willingness to embrace TMC Health’s cultural values: Practice Kindness, Speak-up, Elevate Together, and Be Curious
Proficiency in Microsoft Excel and exposure to financial modeling concepts preferred
Basic understanding of financial statements and budgeting principles

Job Responsibility

Assist with routine financial tasks such as data collection, basic variance analysis, and report preparation
Support the development and maintenance of financial models used for budgeting, forecasting, and service line analysis
Assist in annual budgeting and periodic forecasting processes by gathering data and preparing supporting schedules
Compile and organize financial and operational data to support decision-making
Help prepare monthly and quarterly financial reports, including basic variance explanations and KPI tracking
Support cost accounting and productivity analysis through data validation and reconciliations
Assist with business cases for new programs, services, and capital investments by preparing financial inputs
Provide analytical support for payer reimbursement and contract modeling projects under supervision
Collaborate with Finance team members on special projects and ad hoc analyses
Participate in meetings with Finance and operational teams for learning and exposure purposes

Fulltime

Director - Health System Intelligence

GlobalData is an information services business on a mission to help our clients ...

Location

United States , NYC

Salary:

175000.00 - 220000.00 GBP / Year

360 Resourcing Solutions

Expiration Date

Until further notice

Requirements

10+ years' experience in health policy, health systems, workforce, health economics, or related fields
Master's or doctorate in public health, health policy, health economics, business, or a related discipline
Deep understanding of the U.S. healthcare ecosystem, including payers, providers, health systems, and patients
Proven success managing complex consulting engagements for government, healthcare, or association clients
Strong record of publications, white papers, reports, or thought leadership
Excellent communication and presentation skills for technical and non-technical audiences

Job Responsibility

Define and execute the strategic vision for the Health System Intelligence practice, aligning service offerings with evolving client needs and market trends
Set and uphold quality standards for all analytical work products, ensuring methodological rigor and policy relevance
Integrate GlobalData’s proprietary data assets, simulation models, and databases to differentiate client engagements
Collaborate with leaders across GlobalData’s Life Sciences vertical to develop integrated, multi-disciplinary solutions for complex client challenges
Lead, mentor, and develop a team of consultants, fostering a culture of analytical excellence and continuous learning
Oversee recruiting, onboarding, and professional development to build and sustain practice capacity
Promote a collaborative environment that encourages knowledge sharing with colleagues in sales, research, and client success
Serve as senior relationship manager for government, association, and health system clients, building trusted long-term partnerships and ensuring client satisfaction and retention
Engage clients at the executive level to understand strategic priorities, define project objectives, and ensure delivery of high-value insights
Lead identification and pursuit of new business opportunities

What we offer

Training and coaching that support in building a long-term career
LinkedIn Learning and ongoing Learning and Development opportunities
Competitive compensation
Generous PTO policy
Health, Dental and Vision insurance
Pet Insurance
Company sponsored Life insurance, AD&D, STD, and LTD
Maternity and Paternity leave
401k Match
Corporate gym rates and other discounts

Fulltime

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System Manager Payer Analytics Economics

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System Manager Payer Analytics Economics

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