Description Job Schedule:
Full Time Standard Hours:
40 Job Shift:
Shift 1 Shift Details:
Work where every moment matters.
Every day, over 30,000 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.Department Description:
Integrated Care Partners (ICP) is a physician-led, clinically integrated health care network whose mission is to assist our members in providing the highest quality care at the most reasonable cost for our patients in the current, rapidly changing medical environment.Position Summary:
On behalf of ICP Managed Care, organizes, leads, and/or participates with cross-functional projects related to a variety of internal (i.e., organizational, system, business initiative), and external (i.e., federal, state, payer) changes impacting revenue and profitability. In particular, leads effort to synthesize Managed Care into Growth Initiatives identified by organizational Planning, Business Development, and Strategy.
Ensures accurate assessment of projected revenue, appropriately challenging Region and Institute leadership to ensure correctly valuation, and ensure Managed Care’s comprehension of initiative to secure favorable results as contracts renew. Participates consistently and responds on behalf of Managed Care to requests for impact and information within established timeframes.
For all projects, works with Managed Care cohorts to measure potential financial impacts and document related concerns, barriers to success, and possible solutions. Works cooperatively to identify and correct issues related to contract language, methodologies and/or rates.
Develops workflows and processes to support the analysis of Growth Initiatives and other changes across the organization. Exerts influence throughout the organization to ensure Managed Care’s representation, and ensure workflows are followed and all appropriate actions are taken. Routinely summarizes project progress for executive leadership.Position Responsibilities:
- Represents Managed Care on projects related to a variety of internal & external changes impacting revenue and profitability, building relationships, and raising awareness of Managed Care’s impact to successful growth and other change initiatives
- Works with Managed Care cohorts to document concerns, etc. related to potential changes and value financial risks of initiatives (including LOS reductions, rate actions triggering payer steerage programs, etc.) and providers
- Engages payers to ensure services are covered as well as coordinates the valuation of payer policy changes
- Develops workflows and processes to support the analysis of Growth Initiatives and other changes across the organization
- Routinely summarizes project progress for ICP executive leadership
- Proactively monitors industry related news for related trends in healthcare, and/or proposed legislative changes which would impact revenue and utilization of offered services
Manager of Payer Analytics & Reporting
BA/BS degree in Healthcare, Finance or Mathematics is required. Experience:
At least five (5) years of health care related experience with project management focus. Project management focus on Hospital and physician contracting experience is preferred.Licensure, Certification, Registration:
Health care coding certification is preferred.Knowledge, Skills and Ability Requirements:
We take great care of careers.
- Leadership experience with proven ability to effectively direct and manage change.
- Superior ability to collaborate and influence individuals across the organization to develop and to follow processes to support the accurate assessment of Growth Initiatives
- Comfortable challenging all levels of the organization
- Deep knowledge of current and evolving provider payment methodologies (with a focus on hospital and physician) including the advantages and the risks associated with those methodologies
- Demonstrated detailed knowledge on health care billing and coding including knowledge of claim forms
- Broad knowledge of health care finance and/or accounting issues
- Project management and excellent organizational experience required
- Advanced analytic and problem solving skills required, including experience working with large data sets using Excel; SQL or other system experience a plus
- Knowledge of EPIC system a plus
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.