Analyst Payer Analytics
Company: Dignity Health System Office
Location: Rancho Cordova
Posted on: May 16, 2022
CommonSpirit Health is a nonprofit, Catholic health system
dedicated to advancing health for all people. It was created in
February 2019 through the alignment of Catholic Health Initiatives
and Dignity Health. CommonSpirit Health is committed to creating
healthier communities, delivering exceptional patient care, and
ensuring every person has access to quality health care. With its
national office in Chicago and a team of approximately 150,000
employees and 25,000 physicians and advanced practice clinicians,
CommonSpirit Health operates 137 hospitals and more than 700 care
sites across 21 states. In FY 2019, Catholic Health Initiatives and
Dignity Health had combined revenues of nearly $29 billion and
provided $4.45 billion in charity care, community benefit, and
unreimbursed government programs.
Facebook - LinkedIn -
Job Summary / Purpose The Analyst, Payer Analytics & Economics
performs complex managed care payer financial analysis, strategic
pricing and payer contract modeling activities for a defined payer
portfolio. Provides analytical and pricing expertise for the
evaluation, negotiation, implementation and maintenance of managed
care contracts between CommonSpirit Health providers and payers.
Recommends strategies for maximizing reimbursement and market
share. Provides mentorship and guidance of Analyst contract
modeling. Provides analysis findings and education to key
This position will serve and support all stakeholders through
ongoing educational and problem-solving support for managed care
payer reimbursement models. This position requires daily contact
with senior management, physicians, hospital staff, and managed
care/payer strategy leaders.
Essential Key Job Responsibilities Lead payer contract modeling
strategy and consolidation for large managed care payer
negotiations. Act as a liaison between CommonSpirit Health and
payer to update information and communicate changes related to
Perform complex strategic pricing analysis to support the
negotiation and implementation of appropriate reimbursement rates
and associated language, between physicians/hospitals and
payers/networks for managed care contracting initiatives. Develop
and approve financial models and payer performance analysis.
Monitor contract financial performance. Analyze and publish managed
care performance statements and determine profitability. Review and
accurately interpret contract terms, including payer policies and
procedures impacting contract performance.
Provide training and oversight of the modeling of proposed/existing
payer contracts negotiated by payer strategy and operations,
including expected and actual revenues/volumes, past performance,
proposed contract language and regulatory changes.
Prepare complex service line reimbursement analyses and financial
performance analyses. Develop methods and models (involving
multiple variables and assumptions) to identify the
implications/ramifications/results of a wide variety of new/revised
strategies, approaches, provision, parameters and rate structures
aimed at establishing appropriate reimbursement levels.
Identify, collect, and manipulate from a wide variety of financial
and clinical internal data bases (e.g. PIC, STAR, TSI, PCON, EPIC)
and external sources. Identify and access appropriate data
resources to support analyses and recommendations.
Prepare and effectively present results to senior leadership, and
other key stakeholders, for review and decision-making
Maintain knowledge of operations sufficient to identify causative
factors, deviations, allowances that may affect reporting findings.
Ability to translate operational knowledge to identify unusual
circumstances, trends or activity and project the related impact on
a timely, pre-emptive basis.
Provides leadership, oversight and training for Payer Analytics &
Analyst contract modeling activities.
Bachelor's Degree in Business Administration, Accounting, Finance,
Healthcare or related field. Equivalent education and experience,
in related field may be considered in lieu of degree.
Minimum of one (1) year of experience in financial healthcare
reimbursement analysis is required, including an understanding of
national standards for fee-for-service and value-based provider
including an understanding of national standards for
fee-for-service and value-based provide reimbursement
Experience in contribution to profitability through detailed
financial analysis and efficient delivery of data management
strategies supporting contract analysis, trend management,
budgeting, forecasting, strategic planning, and healthcare
Basic technical understanding and proficiency in MS Excel, MS
Access, MS Visual Basic, PIC, SQL, or other related
Working knowledge of healthcare financial statements and accounting
Ability to use and create data reports from health information
systems, databases or national payer websites (EPIC, EPSI, PIC, SQL
Proficiency in reading, interpreting and formulating computer and
A compensation range of $66,000 - $80,000 is the reasonable
estimate that CommonSpirit in good faith believes it might pay for
this particular job based on the circumstances at the time of
posting. CommonSpirit may ultimately pay more or less than the
posted range as permitted by law.
While you're busy impacting the healthcare industry, we'll take
care of you with benefits that include health/dental/vision, FSA,
matching retirement plans, paid vacation, adoption assistance,
annual bonus eligibility and more!
Keywords: Dignity Health System Office, Rancho Cordova , Analyst Payer Analytics, Professions , Rancho Cordova, California
Didn't find what you're looking for? Search again!