Payer Performance Analyst

UAB Medicine; Birmingham (AL); On-site; USD 74,000 - 120,000; Full time

Benefits offered by this job

Educational assistance programs

Paid time off

Wellness programs

Paid parental leave

PSLF program eligibility

Job summary

UAB Medicine in Alabama seeks a data analyst for the Managed Care Contracting (MCC) team to analyze data and prepare reports that support decisions on program outcomes and payer performance. The role includes market research to understand industry trends and acting as a liaison between internal stakeholders and the MCC department to resolve challenges.

Responsibilities include creating internal/external reporting schedules for negotiations, performance trending, and ad hoc requests, and

Qualifications

• Bachelor's Degree in a related field and four (4) years of experience with health insurers or health systems in revenue cycle, contracting, provider service, patient service or related functions required.
• Master's Degree preferred; EPIC experience and financial expertise a plus.

Responsibilities

• Analyze data and prepare reports to support decision-making regarding program outcomes and payer performance.
• Perform market research supporting MCC understanding of changing marketplace and industry trends.
• Serve as a liaison between internal stakeholders and Managed Care Department to resolve challenges and questions.
• Create schedules related to internal and external reporting for negotiations and performance trending.
• Establish processes for organizing and aggregating data for retrieval and analysis for trending reports and contract pricing insights.

Skills

Analytical skills

Learn new systems

Independent work

Prioritization

Written and verbal communication

Education

Bachelor's Degree in related field

Master's Degree preferred

Tools

EPIC

Job description

Position Overview

Pay range: $73,945 - $120,165 / year

Benefits and perks available for eligible positions include:

• robust educational assistance programs
• generous paid time off
• employee assistance and wellness programs
• paid parental leave
• qualifying employer for the Public Service Loan Forgiveness (PSLF) Program, plus more.

Job Description

To analyze data and prepare reports to support decision-making regarding program outcomes, payer performance, and other correlative issues related to Managed Care Contracting (MCC) needs. To perform market research supporting MCCs understanding of changing marketplace and industry trends. To serve as a liaison between internal stakeholders and Managed Care Department in resolving challenges and answering questions. To help achieve organization and structure within the Managed Care Contracting department. To work with managed care team to create schedules related to internal and external reporting for negotiations, performance trending, standing meetings, stakeholder ad hoc requests. To perform analytics to identify payer issues related to payer behavior and expected versus collected trending by payer for all entities (both in aggregate and to isolate by facility/ physician group).

Key Duties & Responsibilities

• Analyzes data and prepares reports to support decision-making regarding program outcomes, payer performance, and other correlative issues related to Managed Care Contracting (MCC) needs. Performs market research supporting MCCs understanding of changing marketplace and industry trends.
• Serves as a liaison between internal stakeholders and Managed Care Department in resolving challenges and answering questions. Helps achieve organization and structure within the Managed Care Contracting department.
• Work with managed care team to create schedules related to internal and external reporting for negotiations, performance trending, standing meetings, stakeholder ad hoc requests.
• Establishes and document processes for organizing and aggregating data for retrieval and analysis for trending reports, potential incentives versus actual earned trending by payer, program and measure for all contracts, and Medicare quality programs.
• Documents pricing and calculates expected and trends the historical performance.
• Solicits input from various stakeholders and attends meetings. Shares information from cross functional teams to integrate knowledge into processes. Attends cross functional meetings and works closely with key revenue cycle areas to share knowledge related to the upcoming requirements and activities.
• Works closely with the Managed Care Team to discuss issues, trends and observations in the data and infrastructure that could help to better organize and/or operationalize Contract Management.
• Pulls and reviews payer performance reporting to ensure accuracy and clarity of reporting. Creates a scorecard for each payer by entity.
• Performs analytics to identify payer issues related to payer behavior and expected versus collected trending by payer for all entities (both in aggregate and to isolate by facility/ physician group).
• Works with managed care team to create schedules related to internal and external reporting for negotiations, CDM reporting requirements, standing meetings, stakeholder ad hoc requests.
• Establishes and documents processes for organizing and aggregating data for retrieval and analysis for trending reports, modeling, identifying, and quantifying the scope of payer contract compliance issues.
• Performs other duties as assigned.

Qualifications

Bachelor's Degree in a related field and four (4) years of experience working with health insurers or health systems in revenue cycle, contracting, provider service, patient service or related functions required. Master's Degree preferred.

EPIC experience and financial expertise a plus.

Knowledge / Skills / Abilities

• Working knowledge of Revenue Cycle operations and strategies, public and/or private sector health insurance, and related benefits
• Strong analytical skills
• Ability to learn new systems
• Ability to work independently
• Prioritization skills
• Written and verbal communication skills

Why Work at UAB Medicine

We are UAB Medicine, Alabama’s largest and most comprehensive health system, recognized nationally for delivering world-class patient care, pioneering research, and cutting-edge medical education. We proudly serve more than 1.2 million patients each year – from every county in Alabama, all 50 states, and many countries around the world. Our network spans numerous hospitals, emergency departments, more than 67 other sites of care, and a team of over 3,100 physicians. Our key facilities include UAB Hospital - ranked the No. 1 hospital in Alabama by U.S. News & World Report and home to the state’s first ACS-verified Level I adult trauma center and only Magnet-designated hospital - along with UAB Hospital-Callahan Eye and five UAB St. Vincent's hospitals serving central Alabama.

UAB Medicine offers careers across a wide range of practice environments, from our internationally renowned academic medical center and award-winning community hospitals to our primary and specialty care clinics across the state. Whether you’re seeking the fast-paced learning environment of a tertiary care setting or the close-knit environment of a community facility, there’s a place for you on our team where you can become part of a mission-driven organization committed to delivering life-changing care. With nearly every medical specialty represented and unlimited opportunities for growth, you’ll find the right fit for your skills and career goals. We care for you by offering comprehensive, industry-leading benefit packages to support the individual preferences and circumstances of our diverse staff.