Senior Payer Analytics and Economics Analyst

This is a remote position. The Senior Analyst, Payer Analytics & Economics performs complex managed care payer financial analysis, strategic pricing and payer contract modeling activities for a defined payer portfolio. Provides analytical and pricing expertise for the evaluation, negotiation, implementation and maintenance of managed care contracts between CommonSpirit Health providers and payers. Recommends strategies for maximizing reimbursement and market share. Provides mentorship and guidance of Analyst contract modeling. Provides analysis findings and education to key stakeholders. This position will serve and support all stakeholders through ongoing educational and problem-solving support for managed care payer reimbursement models. Lead payer contract modeling strategy and consolidation for large managed care payer negotiations. Act as a liaison between CommonSpirit Health and payer to update information and communicate changes related to reimbursement. Perform complex strategic pricing analysis to support the negotiation and implementation of appropriate reimbursement rates and associated language, between physicians/hospitals and payers/networks for managed care contracting initiatives. Develop and approve financial models and payer performance analysis. Monitor contract financial performance. Analyze and publish managed care performance statements and determine profitability. Review and accurately interpret contract terms, including payer policies and procedures impacting contract performance. Provide training and oversight of the modeling of proposed/existing payer contracts negotiated by payer strategy and operations, including expected and actual revenues/volumes, past performance, proposed contract language and regulatory changes. Prepare complex service line reimbursement analyses and financial performance analyses. Develop methods and models (involving multiple variables and assumptions) to identify the implications/ramifications/results of a wide variety of new/revised strategies, approaches, provision, parameters and rate structures aimed at establishing appropriate reimbursement levels. Identify, collect, and manipulate from a wide variety of financial and clinical internal data bases and external sources. Identify and access appropriate data resources to support analyses and recommendations. Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision-making activities. Maintain knowledge of operations sufficient to identify causative factors, deviations, allowances that may affect reporting findings. Ability to translate operational knowledge to identify unusual circumstances, trends or activity and project the related impact on a timely, pre-emptive basis.