Open position

Job Type: Regular

Time Type: Full time

Work Shift: Day (United States of America)

FLSA Status: Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Under the supervision of the Executive Director of Contract Finance, the Manager, Medical Economics will be responsible for the oversight of the data systems, processes, and analysis to support financial operations and modeling. The Manager will provide the overall leadership for the production of the quarterly and year end settlement of shared risk contracts under the Funds Flow and the maintenance of all systems and work flows that support this process. The Manager will collaborate with cross-functional leadership in finance, contracting, quality, enrollment and may serve as a project leader for complex data modeling or analysis. The Manager is also responsible for recruitment, coaching and managing the analysts on the team and designing roles for the staff that provide growth opportunities to ensure their continued career development.

Job Description:

Essential Duties & Responsibilities including but not limited to: 
1.    Manage team members building and maintaining the data warehouse and related data systems in support of production of financial analysis relating to performance and settlement of shared risk contracts for BILHPN and individual Risk Units.
2.    Oversee the production of quarterly and year end settlement of shared risk contracts under the Funds Flow and all related financial processes such as creation of payor risk rosters, withhold return, and quality incentive distribution.
3.    Lead the implementation of approved changes in the Funds Flow model and the expansion of the data warehouse as needed with supporting enhancements. Apply in-depth knowledge of reimbursement methodologies, risk-based payor contracts, trends in managed care finance, and actuarial concepts including IBNR.
4.    Through clear written and oral communication, explain key analytical findings to all levels of staff and external stakeholders, including Member Physician, hospital leadership and, in collaboration with leadership, relaying information on key aspects of payor contract performance and projected trends.
5.    Develops presentations to review financial performance of risk contracts for internal leadership and various committees including but not limited to Contracts & Finance and Board.
6.    Prioritize projects, assign resources and create timeline estimates in a manner consistent with organizational financial and strategic goals.
7.    Manage stakeholder's expectations and ensure consistency, accuracy, and timeliness of data and analysis for internal and external customers.
8.    Is responsible for assuring training is provided to analysts on the team.  Manages analysts’ time efficiently and allocates resources appropriately to assure successful completion of projects at hand.
9.    Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
10.    Communicates effectively with cross-functional teams.
11.    Carriers out cross functional tasks to achieve critical organizational milestones.
12.    Uses critical thinking skills to analyze information, develops solutions and proposes alternative action plans.

Organizational Requirements:

• Maintain strict adherence to all BILH and BILHPN Policies.
• Maintain courteous and effective interactions with colleagues and providers and stake holders.
• Demonstrate an understanding of the job description, performance expectations, and competency assessment.
• Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to customer service standards.
• Participate in departmental and/or interdepartmental quality improvement activities. 
• Participate in and successfully completes Mandatory Education.
• Perform all other duties as needed or directed to meet the needs of the department.

Minimum Qualifications:

Education:

Bachelor’s Degree or an MBA with Healthcare management focus

Licensure, Certification & Registration: N/A

Experience:

A minimum of 5-8 years of work experience in healthcare industry and 2-4 years supervisory/management experience required

Skills, Knowledge & Abilities:

• Thorough understanding of the healthcare industry and risk-based contracting, strong technical and communication skills, and ability to work in a fast-paced environment.
• Knowledge of SQL database environments and advanced excel skills.
• Understanding of SQL and SAS required.
• Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint and other web- based applications. May produce complex documents, perform analysis and maintain databases.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled