Mgr Prov Contracting Financial Analytics

Job Summary:

The Manager, Provider Contracting Analytics is responsible for the day to day operations of the Provider Contracting Analytics area focusing on providing analysis and modeling regarding health partner contracts.

Essential Functions:

  • Executes the strategic direction for team
  • Ensure the Contracting Analytics function proactively collaborates with and provides support for analyses being conducted by areas outside the department
  • Investigates opportunities for contracting improvements with existing partners and identifies areas for network optimization.   Identifies issues related to reimbursement and recommends appropriate solutions
  • Identify and translate into action plans industry best practices for contracting, including contract structure, modeling, and reporting
  • Actively participate in operational calls with key providers or network partners as needed
  • Develops and provides actionable recommendations to senior management relative to all analysis and/or ad hoc reporting
  • Track and report historical results of network optimizations
  • Ensure all governing body regulations are adhered to at all times for existing and future lines of business
  • Support the budgeting and forecasting processes
  • Build and strengthen provider relationships by facilitating quality service
  • Ensure integrity of information obtained for analysis; keep up-to-date knowledge of the technical systems, claims processing initiatives, and CareSource payment policies
  • Provide guidance and mentorship to analysts
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor of Science/Arts Degree in accounting, finance, economics, computer sciences or related field or equivalent work experience is required
  • Masters or other advance degree in related field is preferred
  • Minimum five (5) years of professional level experience performing a broad range of data analysis required, preferably in healthcare contracting and/or financial field
  • Prior management experience preferred
  • Experience communicating and presenting to senior leadership preferred
  • Provider contracting experience is preferred
  • Managed care or healthcare experience is preferred

Competencies, Knowledge and Skills:

  • Advanced proficiency with Microsoft Suite to include Word, Power Point and Outlook
  • Expert proficiency with Microsoft Excel
  • Intermediate knowledge of SQL, SAS, R or other statistical software 
  • Knowledge of health care reporting standards
  • Ability to work independently and to manage multiple priorities with limited resources
  • Ability to effectively report data, analyze facts, and exercise sound business judgement when making recommendations
  • Ability to analyze problems, draw conclusions, develop processes and communicate status and results
  • Excellent oral and written communication skills
  • Ability to interact with executive levels of management as well as external stakeholders
  • Auditing skills
  • Strong interpersonal, leadership and relationship building skills and high level of professionalism
  • Ability to lead and direct the work of others including the development motivation and rewarding of staff

Licensure and Certification:

  • None

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:
$87,000.00 - $152,300.00

Compensation Type: