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Payer Analyst (Modeling) / Managed Care Contracting

Requisition ID:

21164183

Business Unit:

Hartford HealthCare Corp.

Location:

Wethersfield, CT

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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 SUMMARY

Reporting 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 will

Assist 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 RESPONSIBILITIES

Key Areas of Responsibility

Work 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 RELATIONSHIPS

Job Title of Individual(s) Reports To:  Director, Payer Analytics & Reporting

# Workers Responsible For   # Direct Reports  0 # In-Direct Reports 0

Qualifications

REQUIREMENTS AND SPECIFICATIONS

Minimum Requirements

Education

BA/BS degree

Experience:

2 years of hospital and physician contract related experience

Critical thinking skills required

Analytic and problem solving skills required, including experience working with large data sets using Excel, SQL, Tableau or other system experience

Strong interpersonal and communication skills essential as well as demonstrated ability to work collaboratively across functional areas

Knowledge regarding current and evolving provider payment methodologies with a focus on hospital and physician

Knowledge of governmental payment structures

Knowledge of EPIC system a plus

Broad knowledge on billing and coding as well as broad knowledge of health care finance and/or accounting issues

Customer service focus

Preferred Requirements

Education

BA/BS degree in Health Care, MIS, Finance, Statistics or Mathematics

Experience:

5 years of hospital and physician contract modeling related experience

Knowledge, Skills and Ability Requirements:

Critical thinking skills required

Analytic and problem solving skills required, including experience working with large data sets using Excel, SQL, Tableau or other system experience

Strong interpersonal and communication skills essential as well as demonstrated ability to work collaboratively across functional areas

Knowledge regarding current and evolving provider payment methodologies with a focus on hospital and physician

Knowledge of governmental payment structures

Knowledge of EPIC system a plus

Broad knowledge on billing and coding as well as broad knowledge of health care finance and/or accounting issues

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.

 
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