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Analyst Reimbursement Economics

Company: Catholic Health Initiative
Location: Englewood
Posted on: May 3, 2021

Job Description:


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 leaders.


  • 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 methodologies.
  • 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 Sheets.
  • Basic technical understanding and proficiency with other MS Office tools and Google Workspace (G-Suite).
  • Experience with SQL, SAS, PowerPivot and/or PowerQuery a plus.
  • Working knowledge of healthcare financial statements and accounting principles.
  • Ability to use and create data reports from health information systems, databases or national payer websites (EPIC, EPSI, PIC, SQL Databases, etc.)
  • 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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