At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.

SUMMARY

The Senior Analyst, Managed Care Analytics and Insights is directly responsible for financial analysis, reimbursement modeling, as well as the monitoring and management of financial performance data related to managed care contracts (Commercial and Government) for the Bon Secours Mercy Health system. The scope of the contracts includes hospitals, physicians and ancillary services. The position collaborates with Managed Care Contracting, Decision Support, Revenue Cycle, Patient Financial Services, Finance, Business Development and regional operations, as necessary.

*This is a remote position and you can work anywhere within the continental US (not just OH).

ESSENTIAL JOB FUNCTIONS

• Consults, contributes and participates in managed care contract negotiations for assigned payers (moderate to high complexity). Prepares financial analyses, conducts reimbursement modeling and assists in developing the proposal. Performs activities using Contract Management/Decision Support systems and Excel. Oversees and reviews the work of analysts.

• In conjunction with Contracting, works directly with assigned payers regarding contract interpretation and implementation

• Assists with strategic pricing when modeling scenarios so that BSMH is allocating dollars in each of our market and facilities in the best possible service lines

• Tracks ongoing financial performance, service volume and key utilization data of assigned managed care contracts. Develops and provides regular reports to management both at the region and system level.

• Performs portfolio financial analyses on contract activity for hospitals, physicians, and ancillary services including volume of services, volume and profitability trends, cost and charge structures, volume and profitability by service and by contract, payer migration studies, and other analyses necessary to support the accuracy and profitability of managed care contracting initiatives. Prepares regular reports to management at the regional and system level.

• Assists Managed Care Analytics team with the standardization and continuous improvement of processes, reporting and approaches to managed care analytics.

• Support the design and implementation of Bon Secours Mercy Health strategic initiatives with assigned payers. Develop and support strategic partnerships through improved collaborations both internally and externally.

• Mentors analysts to continuously develop skills and increase departmental capacity

• Participates in short and long term projects, as needed.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

EMPLOYMENT QUALIFICATIONS

Required Minimum Education:

4 year/ Bachelors Degree

Specialty/Major:

In Business Administration, Healthcare Administration or closely related field.

Preferred Education:

Graduate Degree (Masters)

Specialty/Major:

In Business Administration, Healthcare Administration or closely related field

Minimum Years and Type of Experience:

• Three or more years of relevant experience is required.

• Epic certification is preferred

• Prior experience with contract management/contract modeling systems.

• Prior experience with health care reimbursement operations is preferred (e.g. revenue cycle on the provider side and/or network operations on the payer side).

Other Knowledge, Skills and Abilities Required:

• Strong analytical, critical thinking, verbal and presentation skills.

• Ability to establish effective working relationships with internal customers and external business partners.

• The best candidates will display innate curiosity, attention to detail and a passion for solving problems with a positive, willing attitude.

• Deep understanding of health care reimbursement terminology and practices.

• Driven to maintain knowledge of the current trends and developments in the healthcare industry to include: service delivery, reimbursements, compliance/regulations, policies & procedures of Commercial and Governmental payers.

• Proficient in the use of database programs and Excel.

Many of our opportunities reward* your hard work with:

Comprehensive, affordable medical, dental and vision plans

Prescription drug coverage

Flexible spending accounts

Life insurance w/AD&D

Employer contributions to retirement savings plan when eligible

Paid time off

Educational Assistance

And much more

*Benefits offerings vary according to employment status

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com