Sr. Analyst, Managed Care
The Sr. Analyst, Managed Care responsibilities include complex data and financial analysis, financial interpretation of contract terms, contract modeling, data validation, development of reimbursement methodologies and preparation of contract proposals utilizing sound rationale. The candidate must confidently present work product and make recommendations to leaders and executives that influence decision-making and optimize revenue. The candidate will support the organization by providing consultative and analytic support related to managed care, strategic initiatives, and other ad hoc analytic support as identified.
Responsibilities
- Complete financial impact analysis of all contract activity, including modeling of contract financial terms, developing proposals, and recommending areas for revenue improvement.
- Monitor financial performance of current contracts including consideration of methodology and fee changes due to payor or source updates (CMS, Medicaid, etc.).
- Extract, validate, and manipulate large datasets utilizing programming skills such as SQL, SAS, or Python.
- Strategic financial analytics to include financial managed care impacts/forecasts related to increased services, new technology, or expanding service area.
- Present analytic findings with clear and concise work products in Excel, Tableau, and Power BI.
- Collaborate with Finance and Managed Care leadership to inform financial forecasts with year-over-year impacts of all contractual changes.
Educational Requirement
- Bachelor’s degree (or higher) in Statistics, Mathematics, Engineering, Finance, Health Administration, or other closely related fields.
Required Work Experience
- 4+ years of experience in healthcare analytics role.
- 3+ years of experience with SQL or other similar programming language to include creating, editing, and executing code to successfully manipulate and extract large datasets.
- 4+ years of experience in demonstrated ability to present data and analytic observations through impactful visual storytelling.
- Advanced proficiency in Excel including extensive experience in the use of complex formulas and pivots.
Preferred Skills
- Prefer candidate with experience utilizing professional or facility claims data.
- Prefer candidate with experiencing managed care contract terms.
- Prefer candidates with exposure to CMS professional payment methodology (i.e. CMS MPFS).
- Prefer candidate with experience in creating and optimizing Tableau dashboards for effective storytelling.