Payer Analyst (Modeling) / Managed Care Contracting job

company building Hartford Healthcare location Wethersfield, CT
256
Payer Analyst (Modeling) / Managed Care Contracting
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329
jobs in
Wethersfield, CT
17
jobs at
Hartford Healthcare
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Company Description

Hartford HealthCare Corporation is an organization that provides healthcare services. The company provides services such as tertiary-care teaching, surgical weight loss, behavioral and mental health, and spine care. Hartford HealthCare provides services to residents of Connecticut. With 7 acute-care hospitals, behavioral health and rehabilitation services, the state's longest-running air-ambulance service,  a physician team, and clinical integration organization, skilled-nursing as well as home health services, and an extensive range of services for seniors, the system provides the full healthcare system with 33,000 colleagues along with a medical staff of 4,000 providers. Hartford HealthCare provides a comprehensive & competitive benefits package including both full-time and part-time workers, with the option to select the perks and benefit levels that are most appropriate for them and their family. These benefits include paid and unpaid absences, flexible spending, basic life & accident insurance, a 401(k) plan, short-term disability insurance, and much more.

Job Description

Description
Job Schedule: Full Time
Standard Hours: 40
Job Shift: Shift 1
Shift Details:

Work where every moment matters.Every day, almost 35,000 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.JOB SUMMARYReporting directly to the Director of Payer Analytics & Reporting, the Payer Analyst will be responsible for assisting with all payer contracting analytics with a focus on hospital and physician. The Payer Analyst willAssist in the build of EPIC reimbursement contracts.Assist the monitoring of contract/payer performance including payer parity.Assist in ad hoc analysis in support of various HHC and Integrated Care Partner initiatives.JOB RESPONSIBILITIESKey Areas of ResponsibilityWork collaboratively with contracting to identify and correct build errors in the EPIC contract management system. Review contracts across the system to identify and recommend areas for consolidation.Support modeling and analysis related to payer contracting efforts on both revenue and margin basis, ensuring models will achieve payer strategy as defined by senior management within allotted timeframes. Key areas of focus are hospital and physician analysis.Work with various departments to identify and correct the drivers related to contract language and rate terms and recommend remediation activities to Director of Payer Analytics & Reporting, responding to initial contract related inquiries within established timeframes with 100% accuracy.Support the development and maintenance of payer tools to continually assess payer performance and parity. Support the development of competitive positioning analysis.Support the development of ad hoc analysis in support of HHC and/or ICP initiatives as assigned; ensuring end results fulfill initial requests or project goals.Support the development of physician fee schedule database and companion physician analytic tools.WORKING RELATIONSHIPSJob Title of Individual(s) Reports To: Director, Payer Analytics & Reporting# Workers Responsible For # Direct Reports 0 # In-Direct Reports 0Qualifications

REQUIREMENTS AND SPECIFICATIONSMinimum RequirementsEducationBA/BS degreeExperience: 2 years of hospital and physician contract related experienceCritical thinking skills requiredAnalytic and problem solving skills required, including experience working with large data sets using Excel, SQL, Tableau or other system experienceStrong interpersonal and communication skills essential as well as demonstrated ability to work collaboratively across functional areasKnowledge regarding current and evolving provider payment methodologies with a focus on hospital and physicianKnowledge of governmental payment structuresKnowledge of EPIC system a plusBroad knowledge on billing and coding as well as broad knowledge of health care finance and/or accounting issuesCustomer service focusPreferred RequirementsEducationBA/BS degree in Health Care, MIS, Finance, Statistics or MathematicsExperience: 5 years of hospital and physician contract modeling related experienceKnowledge, Skills and Ability Requirements:Critical thinking skills requiredAnalytic and problem solving skills required, including experience working with large data sets using Excel, SQL, Tableau or other system experienceStrong interpersonal and communication skills essential as well as demonstrated ability to work collaboratively across functional areasKnowledge regarding current and evolving provider payment methodologies with a focus on hospital and physicianKnowledge of governmental payment structuresKnowledge of EPIC system a plusBroad knowledge on billing and coding as well as broad knowledge of health care finance and/or accounting issuesCustomer service focusWe 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.
This job was posted on Wed Feb 02 2022 and expired on Tue Feb 15 2022.
Minimum $61K/yr
$81K/yr Average
Maximum $106K/yr

Tasks

  • Represent companies in negotiating contracts and formulating policies with suppliers.
  • Develop cost reduction strategies and savings plans.
  • Develop and implement purchasing and contract management instructions, policies, and procedures.
  • Prepare bid awards requiring board approval.
  • Direct and coordinate activities of personnel engaged in buying, selling, and distributing materials, equipment, machinery, and supplies.
  • Locate vendors of materials, equipment or supplies, and interview them to determine product availability and terms of sales.
  • Interview and hire staff, and oversee staff training.
  • Prepare and process requisitions and purchase orders for supplies and equipment.
  • Review, evaluate, and approve specifications for issuing and awarding bids.
  • Control purchasing department budgets.
  • Review purchase order claims and contracts for conformance to company policy.
  • Resolve vendor or contractor grievances, and claims against suppliers.
  • Administer online purchasing systems.
  • Maintain records of goods ordered and received.
  • Analyze market and delivery systems to assess present and future material availability.
  • Participate in the development of specifications for equipment, products, or substitute materials.
  • Prepare reports regarding market conditions and merchandise costs.
  • Arrange for disposal of surplus materials.

Skills

  • Reading Comprehension - Understanding written sentences and paragraphs in work related documents.
  • Active Listening - Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • Writing - Communicating effectively in writing as appropriate for the needs of the audience.
  • Speaking - Talking to others to convey information effectively.
  • Critical Thinking - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Active Learning - Understanding the implications of new information for both current and future problem-solving and decision-making.
  • Learning Strategies - Selecting and using training/instructional methods and procedures appropriate for the situation when learning or teaching new things.
  • Monitoring - Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.
  • Social Perceptiveness - Being aware of others' reactions and understanding why they react as they do.
  • Coordination - Adjusting actions in relation to others' actions.
  • Persuasion - Persuading others to change their minds or behavior.
  • Negotiation - Bringing others together and trying to reconcile differences.
  • Instructing - Teaching others how to do something.
  • Service Orientation - Actively looking for ways to help people.
  • Complex Problem Solving - Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
  • Judgment and Decision Making - Considering the relative costs and benefits of potential actions to choose the most appropriate one.
  • Systems Analysis - Determining how a system should work and how changes in conditions, operations, and the environment will affect outcomes.
  • Systems Evaluation - Identifying measures or indicators of system performance and the actions needed to improve or correct performance, relative to the goals of the system.
  • Time Management - Managing one's own time and the time of others.
  • Management of Financial Resources - Determining how money will be spent to get the work done, and accounting for these expenditures.
  • Management of Material Resources - Obtaining and seeing to the appropriate use of equipment, facilities, and materials needed to do certain work.
  • Management of Personnel Resources - Motivating, developing, and directing people as they work, identifying the best people for the job.

Knowledge

  • Administration and Management - Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
  • Economics and Accounting - Knowledge of economic and accounting principles and practices, the financial markets, banking and the analysis and reporting of financial data.
  • Customer and Personal Service - Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
  • Personnel and Human Resources - Knowledge of principles and procedures for personnel recruitment, selection, training, compensation and benefits, labor relations and negotiation, and personnel information systems.
  • Production and Processing - Knowledge of raw materials, production processes, quality control, costs, and other techniques for maximizing the effective manufacture and distribution of goods.
  • Computers and Electronics - Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
  • Mathematics - Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
  • Education and Training - Knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects.
  • English Language - Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
  • Law and Government - Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.

Hartford Healthcare

Description

Hartford HealthCare Corporation is an organization that provides healthcare services. The company provides services such as tertiary-care teaching, surgical weight loss, behavioral and mental health, and spine care. Hartford HealthCare provides services to residents of Connecticut. With 7 acute-care hospitals, behavioral health and rehabilitation services, the state's longest-running air-ambulance service,  a physician team, and clinical integration organization, skilled-nursing as well as home health services, and an extensive range of services for seniors, the system provides the full healthcare system with 33,000 colleagues along with a medical staff of 4,000 providers. Hartford HealthCare provides a comprehensive & competitive benefits package including both full-time and part-time workers, with the option to select the perks and benefit levels that are most appropriate for them and their family. These benefits include paid and unpaid absences, flexible spending, basic life & accident insurance, a 401(k) plan, short-term disability insurance, and much more.
Type

Nonprofit

Size

Large

Location

Multiple locations

Industry

General Hospitals, Niche Health Practitioners Companies, Outpatient Care Centers

Founded

1986

CEO

Elliot Joseph

Website

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