[Remote] System Manager Payer Analytics Economics

Note: The job is a remote job and is open to candidates in USA. CommonSpirit Health is one of the nation’s largest nonprofit Catholic healthcare organizations, delivering integrated health services. The System Manager, Payer will provide strategic leadership for payer relations and contracting, managing a team to negotiate and monitor contracts with health plans. Responsibilities • Manage the labor and operations of the Payer Analytics & Economics team including the hiring, orienting, developing and managing of staff • Oversee quality control and quality assurance of Payer Analytics & Economics analytics deliverables and financial models to support the negotiation and implementation of appropriate reimbursement rates associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives • Review and accurately interpret contract terms, including payer policies and procedures to appropriately contract performance and influence strategic pricing strategies • Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability • Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by payer strategy and operations, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes • Oversee and prepare complex service line reimbursement analyses and financial performance analyses. Develop methods and models (involving multiple variables and assumptions) to identify the implications/ramifications/results of a wide variety of new/revised strategies, approaches, provisions, parameters and rate structures aimed at establishing appropriate reimbursement levels. Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision making activities Skills • Bachelors Other Bachelor's Degree in Business Administration, Accounting, Finance, Healthcare or related field. or Equivalent education and experience in related field(s) may be considered in lieu of degree • Five (5) years of experience in contributing to profitability through detailed financial analysis and efficient delivery of data management strategies supporting contract analysis, trend management, budgeting, forecasting, strategic planning in the healthcare industry • Two (2) years of experience in a supervisory role • Requires some experience with SQL queries and Excel • Strongly prefer hospital or managed care experience • EPIC experience a big plus Company Overview • Common Spirit Health is a healthcare organization that provides research programs, home health programs, and virtual care services. It is a sub-organization of CommonSpirit Health. It was founded in 2019, and is headquartered in Chicago, Illinois, USA, with a workforce of 10001+ employees. Its website is https://www.commonspirit.org. Apply tot his job Apply To this Job