[Hiring] Director, Managed Care Analytics @St. Luke's Health System

Remote Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Director, Managed Care Analytics is responsible for the creation and development of detailed financial models, analyses and reports to support third party payer contract negotiations and optimization of the performance of existing third-party payer relationships. β€’ Develop necessary reports to identify and assess contract performance trends and operational issues. β€’ Educate staff in various departments on new or amended third party payer contract rates, terms, and conditions. β€’ Develop a program of cross-training and maintenance of skills in the use of contract modeling information systems. β€’ Support the leadership team in the identification of potential business opportunities, contract negotiations, and payer relationship development. β€’ Prepare comprehensive reports and presentations to communicate financial findings and recommendations to senior management. β€’ Conduct financial modeling and forecasting to assess the impact of proposed contract changes and new initiatives. β€’ Monitor and evaluate contract performance and financial metrics, identifying trends, variances, and areas for improvement. β€’ Analyze managed care contracts for financial performance, identifying areas for optimization. β€’ Generate regular and ad-hoc financial reports, summarizing key data, trends, and recommendations for decision-makers. β€’ Lead complex or special assignments related to managed care financial analysis. β€’ Provide analytic support across various departments and service lines, ensuring data-driven decisions. β€’ Research and resolve inquiries related to assigned functional areas, offering strategic recommendations. β€’ Collaborate with finance teams and management to review financial information and forecasts. β€’ Apply federal and state regulatory requirements, as well as organizational policies and procedures, to all projects. Qualifications β€’ Bachelor's Degree (math, statistics, business, healthcare administration) β€’ 10 years of relevant experience Requirements β€’ A combined minimum of five (5) years’ experience in statistical and financial analyses, report writing, decision support, and/or third party payer contracting is preferred. β€’ Knowledge of commercial health plans, Medicaid systems (traditional and managed care), as well as federal Medicare Advantage and commercial health insurance exchange programs. β€’ Strong interpersonal skills as well as strong leadership qualities. Benefits β€’ Competitive salary and retirement plans. β€’ Robust benefits package to support teams both professionally and personally. β€’ On-site massages. β€’ On-site counseling via Employee Assistance Program. β€’ Access to the Personify Health Wellness tool. β€’ Formal training and career development offerings to ensure you are meeting your career goals. Apply tot his job
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Virtual RN Hybrid- 1 Day Onsite VRN, 2 Days Olive Branch Med Surg

Remote Full-time

Experienced Full Time Virtual Customer Support Specialist - Exceptional Travel Experience & Customer Satisfaction at Blithequark

Remote Full-time

Manager - Service Experience - Bridgepointe Shopping Center Rack

Remote Full-time

Entry Level Recruiter (Part Time – 100% Remote)

Remote Full-time

Experienced Remote Customer Solution Agent – E-commerce Expert and Problem-Solving Professional for a Dynamic Online Marketplace

Remote Full-time

Remote Customer Service [High-Paying] Jobs - Starting at 19 Per Hour – USA Remote Jobs

Remote Full-time

Experienced Salesforce Data Entry Professional for Global Philanthropy Returnship – Join arenaflex to Make a Difference in the World

Remote Full-time

Experienced Customer Services and Member Experience Specialist – Delivering Exceptional Fitness Experiences and Building Strong Community Connections at blithequark

Remote Full-time

Retention Sales Development Representative - Government Accounts

Remote Full-time

**Experienced Customer Service Agent – Ramp Agent Position at arenaflex Fort Lauderdale, FL**

Remote Full-time
← Back to Home