Analytics and Policy Manager
The Analytics and Policy Manager in the Payor Strategy and Contracting department will offer support to both the Payment Reform and Managed Care subdivisions of the department.
The Analytics and Policy Manager will assist the Payor Strategy and Contracting department by managing all relevant regulatory updates, while also overseeing all analytics related to value-based care programs.
- Coordinate, compile, model and analyze the financial/cost impact of new and existing value based care provider contracts including global payment and risk-sharing arrangements, utilizing complex spreadsheet and/or database applications.
- Work collaboratively with finance staff in support of on-going trend analysis by identifying and analyzing drivers of change in unit cost and the impact of unit cost on medical cost trends by category of care and by service line.
- Monitor contract financial performance and develop managed care performance reports
- Develop service line and physician level reimbursement analyses and models (involving multiple variables and assumptions) to support a variety of new/revised strategies, approaches, and provisions.
- Identify, compile and analyze financial information from all internal and external financial and clinical databases/sources to support analyses. Perform sensitivity analyses and identify risk/exposure associated with operational changes. Develops integrated analyses, projections, routine reports, and presentations to reflect actual performance trends.
- Maintain knowledge of operations sufficient to identify causative factors, deviations, allowances that may affect report findings.
- Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision making activities.
- Research and track regulatory updates and keep relevant departments apprised of legislation, regulations, and other issues of interest, with a particular focus on the impact of changes in federal and state law/policy.
- Collaborate with relevant departments on federal and state law/policy changes and educate leadership and other key stakeholders on impact of such changes.
- Bachelor’s Degree (Masters preferred)
- A comprehensive understanding of current episode payment methods used by CMS and by commercial payers, in addition to other complex reimbursement methodologies
- Knowledge of hospital operations, health/insurance benefit plans, and revenue cycle claims systems
- Attention to detail and the ability to spot errors and inconsistencies
- Previous experience working in health care policy (state and federal) and governmental relations
- Strong communication and organizational skills
- Proficiency in SQL or SAS, and Excel