Sr Payer Analyst / Managed Care Contracting
Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. Position Summary: Reporting directly to the Manager of Payer Contract Analytics, the Sr. Payer Analyst is responsible for payer contracting analytics with a focus on hospital and ancillary. Reviews and monitors contract/payer performance including payer parity. Compares expected reimbursement data to cost performance by service line. Responsible for maintaining payment related tools such as payer rate grids. Responsible for maintaining accurate expected reimbursement build in the EPIC system. Responsible for overseeing ad hoc analysis in support of various HHC and ICP contracting Position Responsibilities: Key Areas of Responsibility 1. Develop analysis in support of payer contracting efforts, including review of cost performance. Key areas of focus are hospital and ancillary analysis. 2. Maintain accurate expected reimbursement build in the EPIC system. 3. Maintain payment related tools such as payer rate grids 4. Maintain a process for final modeling information review 5. Work collaboratively with revenue cycle, medical records/coding and compliance to identify and correct issues. 6. Develop ad hoc analysis in support of HHC and/or ICP contracting initiatives. Working Relationships: This Job Reports To (Job Title): Manager of Payer Contract Analytics Internal: Will engage with PFS, Revenue Cycle, Decision Support, Other Reporting/Analytic Areas as appropriate External: Will engage with payers directly Education
- Minimum: BA/BS degree
- Preferred: BA/BS degree in Health Care, MIS, Finance, Statistics or Mathematics
Experience
- Minimum: 5 years of hospital and physician contract modeling experience
- Preferred: 5 of hospital and ancillary contract modeling experience
Licensure, Certification, Registration
- Preferred: Epic
Language Skills
- English
Knowledge, Skills and Ability Requirements:
- Advanced knowledge/expertise regarding current and evolving provider payment methodologies with a focus on hospital and physician
- Knowledge of governmental payment structures
- Advanced expertise and experience with contract modeling software as well as other financial software including hospital information systems and reporting tools (EPIC)
- Experience working with large data sets
- Advanced Excel ability required
- Tableau/SQL experience a plus
- Demonstrated expertise on billing and coding is required as well as broad knowledge of health care finance and accounting issues
- Knowledge of cost accounting and EPSi highly desired
- Strong interpersonal and communication skills essential as well as demonstrated ability to work collaboratively across functional areas
- Superior analytic and problem solving skills
- Customer service focus
We take great care of careers. With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment. Apply tot his job Apply To this Job