Analyst Reimbursement Economics
Company: Catholic Health Initiative
Posted on: May 3, 2021
Prepares system-wide managed care and value-based agreement
(VBA) reimbursement analytics and reporting. The analyst supports
financial forecasting and budgeting activities for Payer Strategy &
Relationships, detailing the value delivered through fixed rate and
charge master-related trend increases from managed care
negotiations. Prepares detailed reimbursement analyses and
participates in special projects, including recommending strategies
for maximizing reimbursement and market share. Provides analysis
findings and education to key stakeholders.
This position will serve and support all stakeholders through
ongoing educational and problem-solving support for managed care
and VBA payer reimbursement models. This position requires regular
contact with senior management and managed care/payer strategy
- Create and maintain system-wide reimbursement and rate
analytics, economic performance analyses, and comprehensive
reporting tools in support of managed care and value-based
agreements (VBA) and initiatives.
- Prepare VBA analyses and reporting for management and other key
stakeholders. Support the Payer Strategy & Relationships leader
liaison for tracking, reporting, updating, and communicating VBA
participation and performance information.
- Work cross-functionally with finance and revenue cycle on
inputs for managed care reserves, budgeting, and long-range
strategic financial plan.
- Work with data from a wide variety of financial and clinical
internal databases and external sources (e.g., Medicare/Medicaid
website). Identify and access appropriate data resources to support
analyses and recommendations. Identify risk/exposure associated
with various reimbursement structure options. Produce analytical
statistical reports on new ventures, products, services, being
considered. Perform sensitivity analyses on operating and
underlying assumptions such as modifications of charges rates.
- Prepare complex service line reimbursement analyses and
financial performance analyses (involving multiple variables and
assumptions) to identify the implications/ramifications/results of
a wide variety of new/revised managed care and VBA strategies,
approaches, provisions, parameters, and rate structures aimed at
establishing appropriate reimbursement levels.
- Develops and maintains knowledge of operations sufficient to
identify causative factors or deviations 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.
- Bachelor's Degree in Business Administration, Accounting,
Finance, Healthcare or related field. Equivalent education and/or
experience may be considered in lieu of degree.
- Minimum of three (3) years' experience in healthcare finance or
analytics, including an understanding of national standards for
fee-for-service and value-based provider reimbursement
- Experience in financial analysis and/or reporting, contributing
to contract analysis, trend management, budgeting, forecasting,
strategic planning, and/or healthcare operations.
- Intermediate capabilities in MS Excel and/or Google
- Basic technical understanding and proficiency with other MS
Office tools and Google Workspace (G-Suite).
- Experience with SQL, SAS, PowerPivot and/or PowerQuery a
- Working knowledge of healthcare financial statements and
- 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 mathematical rules/formulas.
Keywords: Catholic Health Initiative, Denver , Analyst Reimbursement Economics, Other , Englewood, Colorado
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