Senior Payer Contract Analyst

Jefferson Health; Philadelphia (Philadelphia County); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Jefferson Health is seeking a Senior Payer Contract Analyst to perform scenario modeling and analytics for managed care contract negotiations, monitor performance, and assess regulatory impact. The role retrieves and analyzes data from multiple sources to support the Payer Contracting team as a trusted analytics partner.

You will develop flexible models, maintain key metrics, ensure CMS price transparency compliance, and collaborate with stakeholders to answer critical business questions using

Qualifications

• Bachelor's degree in finance, healthcare admin, business, or related field.
• 5 years in payer-related roles with budgeting and financial analysis.
• Advanced Excel and PowerPoint proficiency.
• Experience building contract modeling tools and BI apps (Qlik/Tableau/PowerBI/EPSi).

Responsibilities

• Conduct contract modeling and analytics for managed care negotiations.
• Aggregate data from multiple sources to support contracting.
• Monitor contract performance and industry trends.
• Ensure CMS price transparency compliance when applicable.
• Identify insights to inform negotiations and decisions.
• Support ad-hoc analytics requests.
• Collaborate with team to deliver analytics as a partner.

Skills

Excel

PowerPoint

Contract Modeling

BI/Data Analytics

Communication Skills

Education

Bachelor's degree in Finance/Healthcare Admin/Business

Master’s degree in Finance/Healthcare Admin/Business (preferred)

Tools

Qlik

Tableau

Microsoft Power BI

EPSi

Job description

Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.

Job Description

Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.

Hybrid:

Travel to the location quarterly

Summary

Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.

Job Duties

• Conduct detailed managed care contract modeling and analysis using available contract modeling systems.
• Build flexible models that aggregate fee-for-service and value-based data from multiple sources and enable scenario play.
• Maintain key department metrics (e.g. Managed Care Financial Reporting package, payer mix, reimbursement benchmarks) and monitoring tools (e.g.contract and rate tracking grids).
• Ensures compliance with all CMS Price Transparency requirements relating to development, accuracy, and publication of machine-readable files.
• Monitor payer policy updates and quantify impact of potential material harm and/or other contract implications.
• Validate payer rate loads to ensure contracts are being executed accurately and perform root-cause analysis of variances.
• Serves as a resource to management to assist in ad-hoc projects.

Minimum Qualifications

• Bachelor’s Degree Finance, Healthcare Administration, Business or related field
• 5 years Experience in payer related position(s) in provider or insurance industry with minimum 5 years experience in budgeting, insurance/payer related financial analysis, net revenue reimbursement modeling and performance computations, decision support, and general financial reporting.
• Intermediate to advanced capabilities with Microsoft Excel and PowerPoint
• Experience building and manipulating Contract Modeling tools and BI/Data Analytics applications (e.g. Qlik, Tableau, Microsoft PowerBI, EPSi).
• Ability to thrive in a fast-paced, agile work environment with high expectations and accountability.
• Excellent written and verbal communication skills.
• Efficient conceptualization, analytical and logic skills.

Preferred Qualifications

• Master’s Degree Finance, Healthcare Administration, Business or related field