[Hiring] Healthcare Contracting Analyst @Brown Medicine

Role Description

The Contracting Analyst reports to the Director, Contract Analytics and Modeling. Under general supervision, produces financial and statistical reports and analytics.

• Assists in the establishment of appropriate contract rates and reimbursement structures.
• Evaluates existing contract performance and forecasts the impact of proposed contract rates.
• Builds and maintains payer contract models in the contract management tool.
• Designs and prepares accurate, timely, and actionable analyses, financial models, dashboards, and reports to support payer contract negotiations and payer relations strategies.
• Conducts research and generates analytics to evaluate the drivers of key trends impacting contract margin performance.
• Synthesizes findings and identifies risks and opportunities.
• Implements and validates payer contract model terms, including the assessment of payment variances for revenue optimization.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence.

• Instill Trust and Value Differences
• Patient and Community Focus and Collaborate

Qualifications

• Bachelor's Degree in Business, Finance, Health Administration or related field.
• Four to six years of experience in healthcare with emphasis in reimbursement, contracting, financial analysis, or forecasting.
• Strong understanding of provider reimbursement methodologies and managed care programs and contracts.
• Strong analytical skills, including the ability to understand complex concepts and develop responsive analyses.
• Highly proficient in Microsoft Office, specifically MS Excel, Access, and PowerPoint.
• Experience in Allscripts EPSi decision support tool preferred.
• Highly organized with strong project management skills.

Requirements

• Conducts in-depth reviews and analysis on the cost and utilization of contracts.
• Provides financial analysis to support contract negotiations and compliance.
• Completes annual reconciliations and settlements.
• Identifies and isolates problems/potential problems and areas for financial improvements.
• Recommends and implements necessary changes.
• Develops financial strategies, plans, and forecasts for all fee-for-service and alternative payment models.
• Develops computer models and reports for tracking and evaluating performance of contracts.
• Assists in the planning and development of negotiation scenarios.
• Maintains effective relationships with clinical and physician leaders, IPAs, Health Plans, and other stakeholders.
• Maintains departmental database to track financial performance of contracts.
• Oversees contract reporting and quarterly performance reports.
• Prepares financial and statistical reports.
• Functions as the finance liaison with health plan representatives.
• Provides value-added analytic support in the development and monitoring of standard and ad hoc cost and utilization reporting.
• Interprets trends, regulatory changes, and forecasts.
• Works with members/clients to implement identified opportunities.
• Leads the development of contracting reports, analysis, and financial reconciliations.
• Supports evaluation of new and existing business opportunities through scenario modeling and financial analysis.
• Identifies and reports quality risks related to contract reporting.
• Drives the development of appropriate program metrics and outcomes.
• Develops data queries and conducts rigorous analyses.
• Collaborates with outside program vendors in analyzing and interpreting outcomes.
• Quantifies the impact of clinical initiatives on overall medical expenses and trends.
• Develops and maintains strategic pricing model.
• Provides analytics to support the development of strategic pricing strategy recommendations.
• Analyzes chargemaster accuracy and develops processes for pricing requests.
• Creates ad hoc pricing reports summarizing benchmarking, cost, and revenue data.

Benefits

• Pay Range: $67,724.80-$111,716.80
• Work Type: M-F 8am-4:30pm (Flexible Times)
• Work Shift: Day
• Daily Hours: 8 hours
• Driving Required: No

Company Description

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.