Job Details

Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.

Job Description

Schedule: Monday - Friday, 8:00 am - 4:30 pm.

Hybrid: Travel to the location quarterly

Summary
Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.

Job Duties

• Conduct detailed managed care contract modeling and analysis using available contract modeling systems.
• Build flexible models that aggregate fee-for-service and value-based data from multiple sources and enable scenario play.
• Maintain key department metrics (e.g. Managed Care Financial Reporting package, payer mix, reimbursement benchmarks) and monitoring tools (e.g.contract and rate tracking grids).
• Ensures compliance with all CMS Price Transparency requirements relating to development, accuracy, and publication of machine-readable files.
• Monitor payer policy updates and quantify impact of potential material harm and/or other contract implications.
• Validate payer rate loads to ensure contracts are being executed accurately and perform root-cause analysis of variances.
• Serves as a resource to management to assist in ad-hoc projects.

Minimum Qualifications

• Bachelor’s Degree Finance, Healthcare Administration, Business or related field
• 5 years Experience in payer related position(s) in provider or insurance industry with minimum 5 years experience in budgeting, insurance/payer related financial analysis, net revenue reimbursement modeling and performance computations, decision support, and general financial reporting.
• Intermediate to advanced capabilities with Microsoft Excel and PowerPoint
• Experience building and manipulating Contract Modeling tools and BI/Data Analytics applications (e.g. Qlik, Tableau, Microsoft PowerBI, EPSi).
• Ability to thrive in a fast-paced, agile work environment with high expectations and accountability.
• Excellent written and verbal communication skills.
• Efficient conceptualization, analytical and logic skills.

Preferred Qualifications

• Master’s Degree Finance, Healthcare Administration, Business or related field

Additional Qualifications

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University Hospitals, Inc.

Primary Location Address

1101 Market, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.    

Jefferson is committed to providing equal educa­tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. 

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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