Provide analytic support for network performance, unit cost trend, network profiling and evaluation, and contract modeling for current health plans, future business, and new products
Utilize applications and tools to support network performance management reporting and analytic needs
Evaluate and monitor financial performance of key provider contracts for health plans
Perform financial analyses to identify medical cost improvement opportunities to develop and execute contracting action plans to achieve results
Perform contract analysis to support contract negotiations including assisting in development of contract modeling tool
Prepare network performance management reports to monitor and measure unit cost trends and network improvement opportunities
Perform detailed contract analysis for executed contracts to evaluate contract terms and rates are meeting expected targets
Research new business state payment methodologies and identify opportunities to improve unit cost management
Collect data requirements from internal and external analytic customers to prepare financial analysis or develop analytic tool/model
Performs other duties as assigned

Requirements

Bachelor's degree in Business, Finance, Accounting, related field, or equivalent experience
2+ years of provider reimbursement and analysis, data/contract analysis and data mining or statistics, preferably in the healthcare industry
Working knowledge of SQL tools, analytical software (SAS, SPSS, etc), and Business Objects/Cognos preferred

Benefits

competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

financial analysiscontract analysisdata miningstatisticsnetwork performance managementcost trend evaluationcontract modelingdata requirements collectionunit cost managementprovider reimbursement