When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
Reporting to the Executive Director of Contract Finance, the Manager, Contracting Analytics will be responsible for the analyses of financial terms of managed care contracts for BILHPN and BILH system providers (e.g. Hospitals, Professional providers, Behavioral Health, Home Care/Hospice). The Manager will provide the overall leadership for the contract language, rate reviews and overall valuations for negotiations and renewals and the maintenance of all systems and work flows that support these processes. The Manager will collaborate with cross-functional leadership in finance, contracting, and medical economics 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:
Conduct analysis, provide input and/or oversee analysis of financial terms of managed care agreements, including valuation of terms in support of contract negotiations and day to day operations. Create and maintain payor, service line and market comparative models Ensure accuracy of the rates and fee schedules and related contract language of managed care agreements against negotiated terms. Provide System Finance with managed care net revenue trend projections based on negotiated contract terms. Notify health plans regarding charge changes and estimate the financial impact to each contract with such language. Support the BILH and BILHPN providers regarding rate or reimbursement questions. 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. Manage presentation of managed care contracted rate summaries and fee schedules and ensure updated in a timely manner for use by internal stakeholders (to verify that negotiated rates have been implemented, etc.). Prioritize projects, assign resources and create timeline estimates in a manner consistent with organizational financial and strategic goals. Manage stakeholder's expectations and ensure consistency, accuracy, and timeliness of data and analysis for internal and external customers. 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. 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. Communicates effectively with cross-functional teams. 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 required; Master’s Degree or similar advanced degree preferred.
Licensure, Certification & Registration:
None
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, provider reimbursement methodologies (for a variety of provider types and including Medicaid & Medicare) and risk-based contracting.
Experience working with a variety of relevant data sources in building complex financial models that value fee for service and risk-based contract terms.
Strong technical and communication skills, and ability to work in a fast-paced environment with shifting priorities. Ability to clearly communicate complex information to leadership.
Knowledge of SQL database environments and advanced excel skills.
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.
Key Relationships:
1
VP, Contracting
2
Director, Contracting
3
Director, Contract Payment Systems
.
4
Manager, Revenue Finance
5
Manager, Decision Support
6
7
Scope/Impact Statement:
Work Schedule: Indicate either Yes or No as appropriate. Hours of work may be subject to change based upon the needs of the business/department.
On Call:
Shift Rotation:
Weekends:
Physical Requirements & Environment: Required
For each category, select ONE option from choices below by placing an X in the space to the left of the entry.
Mental and Visual Attention Required
a)
The position requires basic mental and visual attention much or all of the time
b)
The position requires periods of concentrated mental and visual attention.
c)
X
The position requires a high degree of mental and visual concentration.
Physical Exertion
Weight
d)
X
Nature of work requires lifting or moving light weight (up to 20 pounds).
e)
Nature of work requires lifting or moving medium weight (over 20 and up to 75 pounds).
f)
Nature of work requires lifting or moving heavy weight (over 75 pounds).
Dexterity
g)
X
Flow of work and character of duties require average manual coordination.
h)
Flow of work and character of duties require above average manual coordination.
i)
Flow of work and character of duties require high manual coordination.
Range of Motion
j)
X
Duties require average range of motion.
k)
Duties require above average range of motion.
l)
Duties require high range of motion.
Physical Conditions
m)
Performance of duties allows for variation in positioning and tasks.
n)
X
Performance of duties requires remaining in position for prolonged periods of time.
Repetitive Motion
o)
Assignments require occasional repetitive motion.
p)
X
Assignments require frequent repetitive motion.
q)
Assignments require constant repetitive motion.
Working Conditions
r)
X
Working conditions include minimal exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.
s)
Working conditions include occasional exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.
t)
Working conditions include continuous exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.
Exposure to Hazardous Materials
u)
X
Performance of duties generally does not involve exposure to hazardous materials.
v)
Performance of duties occasionally involves exposure to hazardous materials.
w)
Performance of duties frequently involves exposure to hazardous materials.
Patient Care Conditions (select ALL that are applicable)
x)
Position entails exposure to blood and body fluids, standard precautions must be used.
y)
Assignments include transporting, transfer and positioning of patients.
z)
Incumbent must be continuously prepared to prevent a patient fall.
Sensory Requirements (select ALL that are applicable)
aa)
Performance of duties requires the ability to discern and identify colors
bb)
Performance of duties requires the ability to discern sharp from dull and hot from cold
cc)
Performance of duties requires the ability to hear soft and loud noises
Patient Care/Patient Contact Designation (check only one of the items listed below)
_ Position has a direct impact upon health outcomes of the patient.
_ Position facilitates the process that may impact patient access to services.
X No patient care/contact, and does not facilitate the patient care process or directly impact health outcomes.
This Job Description is intended to describe the general nature and level of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive list of all responsibilities, requirements, duties and skills required of personnel so classified. Additional duties and responsibilities that are specific to the Department or Unit are identified and maintained by the Manager as an Addendum to the Job Description..
Authorization:
Department Management Authorization
Title
Date
Senior Management Authorization
Title
Date
Human Resources/Compensation Authorization
Title
Date
Summary for Job Posting: (For Human Resources Use Only)
Pay Range:
$130,000.00 USD – $160,000.00 USD
The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.
