Senior Medicaid Finance & Payer Analytics Lead

Pscfl; Miami (FL); On-site; USD 140,000 - 190,000; Full time

Job summary

Nicklaus Children's is seeking a Sr. Manager Governmental Analytics to lead financial preparation, modeling and forecasting related to Medicaid funding.

You will support payer strategy initiatives, provide analytics for Ensemble Rev Cycle teams, and assist with Epic/FinThrive implementations. You will develop advanced financial analytics packages for negotiations, lead the Medicaid/Legislative Session financial work, and represent the organization with state CFOs and government relations

Qualifications

• Bachelor's Degree in Business Administration, Healthcare Administration, or related field
• 7-10 years of analytics, forecasting, and executive presentations related to Medicaid financing/reimbursement.

Responsibilities

• Performs and leads complex analytics on Medicaid and Commercial proposals; evaluates financial impact and makes well thought out, logical recommendations.
• Supports contract negotiations with financial analysis that ties together complex, multidisciplinary concepts impacting reimbursement.
• Continuously maintains, creates, and implements automated reporting mechanisms to effectively manage Medicaid, Managed Care, and Value Based business by providing proactive trending/impact by key metrics and statistics.
• Participates in ongoing research of governmental regulations and policies to ensure impact to NCHS/NCPS financial/clinical operations are understood, communicated timely & effectively.
• Works with Senior Leadership on Legislative priorities and complex financial models.
• Continuous engagement and awareness in AHCA related initiatives impacting funding and reimbursement to Children's Hospitals.
• Works cross functionally to operationalize systems and organizational changes required of the task at hand.
• Learns & understands healthcare industry value transformation to continuously tie it back to NCHS Foundational Pillars and successfully incorporates into daily work functions.
• Plays lead role in representing Nicklaus in the Directed Payment Program by developing playbooks on timelines and analytics in support of program and by working closely with outside strategy consultants and attending monthly Statewide and Regional strategy calls.
• Creates and manages a payer data cube to facilitate in depth financial analysis containing various levels of complexity and data slices.
• Manages the analytics planning, support and recommendations to the VP Population Health/Payer Strategy for all NCPS Managed Care Agreements.
• Leads the analysis of NCPS managed care agreements related to MPIP and other Medicaid reimbursement structures.

Skills

Advanced Excel modeling

BI systems

Financial analytics

Contract negotiation support

Data manipulation

Leadership of direct reports

Education

Bachelor's Degree in Business Administration / Healthcare Administration

Master's degree preferred

Tools

FinThrive

MedAssets

Contract management tools

Job description

Nicklaus Children's is seeking a Sr. Manager Governmental Analytics to lead financial preparation, modeling and forecasting related to Medicaid funding.

You will support payer strategy initiatives, provide analytics for Ensemble Rev Cycle teams, and assist with Epic/FinThrive implementations. You will develop advanced financial analytics packages for negotiations, lead the Medicaid/Legislative Session financial work, and represent the organization with state CFOs and government relations