Job ID83555

LocationAurora, Colorado

Full/Part TimeFull-Time

Regular/TemporaryRegular

Why Work at Children's....

Here, it's different. Come join us. Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years. Here, the nation's brightest nurses, physicians, scientists, researchers, therapists, and care providers are creating the future of child health. With an optimist's outlook, a trailblazing spirit, and a celebrated history, we're making new strides every day. We've been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the best of the best pediatric hospitals with #1 rankings in Colorado and the region by U.S. News & World Report. As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300+ outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties. Here, we know it takes all of us, every role, to deliver the best possible care to each child and family we treat. That's why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation. We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through o A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it's different.

Job Overview

The Payment Transformation / Managed Care Reimbursement and Analytics Manager is responsible for overseeing the technical and analytical support related to the evaluation, negotiation, implementation, maintenance and performance reporting of commercial and governmental payer contracts for CHCO across the organization. This position must be able to manage a highly-skilled team of financial analysts while supporting the development of new reimbursement/payment methodologies that are consistent with CHCO's strategic plan and recommending strategies for maximizing reimbursement and mar

Additional Information

Department Name:Decision Support Job Status: Full time, 40 hours per week Shift: Monday to Friday 8am to 4:30pm- Hybrid

Qualifications

EDUCATION - Bachelor's degree is required. EXPERIENCE - Minimum of five (5) years of healthcare and/or payer financial analysis experience. Supervisory experience preferred.

Responsibilities

POPULATION SPECIFIC CARE No direct patient care. ESSENTIAL FUNCTIONS An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform. Proven ability to negotiate complex reimbursement scenarios as an integral part of the negotiation team. Build, manage and mentor a team responsible for gathering, analyzing, and presenting complex financial data related to hospital, provider and clinically integrated network (CIN) payer contracts. Responsible for the design/implementation of complex data analysis processes to support Payer partnership initiatives, such as outcomes reporting, alternative payment models, and shared savings contracting. Direct oversight of all financial models developed and utilized in payer contracting initiatives. Manage the coordination, compilation and modeling of all analyses related to the financial/cost impact of new and existing fee-for-service and value-based care contracts and other alternative payment models, including gl bal payment, risk-sharing arrangements, and funds flow models, utilizing complex spreadsheet and/or database applications. Significant involvement in the hospital, physician, and CIN negotiations and implementation of reimbursement methodologies and associated language for all commercial and governmental payer contracting initiatives. Oversee the development and on-going monitoring of contract financial performance reporting which includes the preparation and delivery of financial results to the CHCO and CIN executive teams. Lead and manage all projects through the various complexities that arise in contract negotiations to completion under time-sensitive deadlines. Keep up to date on trends and regulatory changes and requirements impacting the hospital and physician reimbursement. Responsible for managing department financials.

Other Information