Payer Strategy Analyst

Company: Acord (association For Cooperative Operations Rese
Location: Miami
Posted on: January 28, 2025

Job Description:

Job SummaryLeads support for all governmental and non-governmental payer performance analytics, as well as other service line/operational/clinical/professional analytics, with the ability to utilize various software, systems, and other resources in order to meet or exceed Strategic objectives. Works cross-functionally with internal teams, including but not limited to Finance, Decision Support, Global Health, Revenue Cycle, Patient Access, Nicklaus Children's Pediatric Specialists LLC, to ensure consistency and cross-pollination of ideas and best practices in support of NCHS Pillars.Job Specific Duties

• Supports in the development and implementation of current, and future state, commercial and governmental payer analytics reports.
• Demonstrates expertise and leadership in performing/producing intricate financial analysis utilizing a variety of analytics tools, including but not limited to spreadsheets, contract modeling systems, BI dashboards, decision support systems.
• Serves as FinThrive subject matter expert by providing support/feedback to internal constituents on pricing estimator software utilized to produce self-pay and insured patient responsibility estimates, collaborating with the contract loading team to ensure appropriate interpretation/load of contractual rates, and reviewing/approving FinThrive access requests.
• Possesses working knowledge of South Florida managed care payer environment, as well as commit to continuous learning and development of Statewide/National managed care payer trend in order to round out ability to produce well thought out, relevant and proactive analysis.
• Supports managed care negotiations by ensuring timely and appropriate availability of all reporting and analytics to Director/VP.
• Responsible for timely update and dissemination of a variety of departmental matrices, including but not limited to; payer hospital and employed physician rates/participation, charge master increases/notification, behavioral health rates/participation, DPP payment tracking, and telehealth policies.
• Assists in yearly managed care budget analysis and preparation.
• Reviews and disseminates monthly payer provider bulletins, as well as ad hoc payer communications, to appropriate internal staff.
• Serves as the liaison with the Enterprise Business Intelligence team related to the implementation of Managed Care AI initiatives and innovations.Minimum Job Requirements
  • Bachelor's degree in Business Administration, Health Service Administration, or Finance.
  • 3-5 years of progressive experience in the healthcare field addressing financial analytics, data analysis, and payer performance.Knowledge, Skills, and Abilities
    • MBA or MHA preferred.
    • Strong business and financial background in Managed Care on the provider or payer side preferred.
    • Experience in contract modeling systems highly preferred.
    • Knowledge of managed care payment and contracting methodologies.
    • Proficient in PowerPoint, Excel, and Access.
    • Possess strong analytical skills in order to make sound recommendations.
    • Able to interpret, adapt, and react calmly under stressful conditions.
    • Experience working cooperatively and constructively with internal and external customers.
    • Ability to multitask and pivot as needed.
    • Ability to problem solve to formulate a plan of action.
    • Computer skills including word processing, spreadsheet, presentation software, knowledge in patient information systems (Cerner EMR), data analysis, statistics, and LEAN process improvement methodologies.
    • Ability to read, write and express complex concepts.
    • Able to maintain confidentiality of sensitive information.
    • Strong analytical skills.
    • Able to work independently and handle multiple demands simultaneously.Job: Accounting/FinancePrimary Location: Florida-Miami-NCHS Corporate HeadquartersDepartment: NCHS-MANAGED CARE CONTRACTING-1000-900910Job Status: Full Time
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Keywords: Acord (association For Cooperative Operations Rese, Homestead , Payer Strategy Analyst, Professions , Miami, Florida