Analyst, Payer Relations
Ovation Healthcare
full-time
Posted on:
Location Type: Remote
Location: Tennessee • United States
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About the role
- Collect and validate data from hospitals for modeling, analytics, and presentation.
- Evaluate existing and proposed payer contracts to determine financial feasibility and impact on the organization’s bottom line.
- Model Portal – Maintain all request for all hospital models and maintain tracker
- Analyze and interpret complex managed care contract proposals, including reimbursement methodologies, and load or update contract terms in the designated contract management system.
- Manage data validation for all databases.
- Audit and monitor claim payments from managed care plans to ensure accurate reimbursement according to contract terms.
- Investigate payment variances and discrepancies, identifying root causes for underpayments.
- Assist with data analysis and create tables and forms for Presentation.
- Monitor and manage assigned deadlines for models. Including tracker maintenance and internal communication with consultants
- Assist with regular/ad hoc reporting requests, dashboards for management on payer mix, financial performance, and compliance metrics.
- Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems.
- Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations.
- Graphically/analytically strong; excellent analytical, critical thinking, and problem-solving skills, with meticulous attention to detail.
- Strong communication skills to effectively present complex data to both technical and non-technical stakeholders.
- Track and report on Key Performance Indicators (KPIs)
- Assist with validating financial analysis prior to presenting to hospital or payers
- Maintain and organize client information
- Assist leadership with annual team goals
Requirements
- Minimal travel
- Understanding of managed care contracting and related initiatives are useful but not required as well as the underlying systems that support those initiatives.
- Understanding of Revenue Cycle process is useful but not required.
- BS Preferred
- Advanced knowledge of Microsoft products Excel (VLOOKUPS, Pivot tables, data modeling)
- Familiar with Microsoft Power Point / Power BI
- Experience with Electronic Health Records (EHR) and Billing Systems (i.e. Epic, Cerner) preferred
- Ability to interact with clients and strong communication skills
- Team player
- Organizational skills / multitasking
- Data analysis experience critical
- Critical thinker
- Problem solving skills
- Ability to work in a fast-paced environment independently
Benefits
- Health insurance
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisdata validationfinancial analysisreimbursement methodologiescontract managementKey Performance Indicators (KPIs)data modelingproblem solvingcritical thinkingmultitasking
Soft Skills
strong communication skillsanalytical skillsattention to detailteam playerorganizational skillsindependent workpresentation skillsinterpersonal skillstime managementadaptability
Certifications
BS degree