Sr Analyst, Payer Analytics
Cancer care is all we do
Hope in healing
Cancer Treatment Centers of America® (CTCA), part of City of Hope, takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each individual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard® of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat.
Under the strategic direction of the Manager of Payer Analytics, the Senior Analyst of Payer Analytics will drive payer contracting strategy by performing in-depth contract analytic design, execution, and interpretation. This involves deep dive analytics into payer performance and proposed contract terms to order to make decisions on how to structure payer contracts. This position will participate in the design and interpretation of standard reporting as well as conducting ad-hoc drilldowns for specific business issues. There will be interaction with CEOs and executives across three hospital sites as well as revenue cycle, payer relations, and other leadership teams.
20% Strategy and Insights: Work with payer relations team on analytic design, execution, and interpretation. Deliver and present analytics and interpretation to business leaders in a digestible format. Provide perspective on new analytics to support payer reimbursement and performance. Proactively take steps towards automation or use of new technology. Provide thoughtful perspective in meetings with management. Understand Medicare and commercial reimbursement, policies, and regulatory requirements and apply to contract modeling, insights, and new ideas.
Manage customer expectations and relationships and maintain alignment of deliverables with organization analytic needs. Serve as an expert on payer contract financial terms and financial modeling. Design and interpret analytics, lead training, and respond to questions across multiple departments.
30%| Contract Maintenance: Load, update, and maintain contracts in collaboration with a vendor. Develop and maintain workflows and management processes to ensure there are no errors in contract modeling or loading. Model the effect of fee schedule updates on revenue and percentage of Medicare. Identify, interpret, and make recommendations regarding unclear contract or proposed contract terms.
50%| Analytic Support: For both payer contract negotiations and monitoring, discuss business needs with customer and influence the design of an analysis and execute based on jointly designed specifications. Analyze data to work with colleagues to generate business insights and roll up data into a digestible format. Ability to use data extract and BI tools such as SQL, Qlik, and MicroStrategy. Work with manager to efficiently merge data from multiple databases and find efficient ways to complete reporting.
Skills, Education and Additional Information
- Minimum of bachelor’s degree in Business, Healthcare, Computer Science or related field. Master’s degree in Business Administration or comparable field of study preferred.
- 3 or more years’ experience in a managed care/healthcare environment with exposure to contract management and program development
- Technical ability in ETL and visualization tools such as Tableau, SQL, Qlik, and MicroStrategy
- Knowledge of claims processing systems and guidelines
- Experience with reimbursement methodologies for Medicare and commercial insurance; and regulatory requirements concerning payer contracts.
- Ability to produce analytics that are well-documented and easy to follow
- Analytical skills with the ability to collect, organize, analyze, and disseminate information with attention to detail and accuracy
- Strong written and verbal presentation skills including the ability to translate information to a variety of audiences
- Ability to build strong relationships with internal and external stakeholders
- Ability to be flexible and adapt in order to achieve initiative and organizational goals
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us. Visit: Jobs.cancercenter.com to begin your journey.
We win together
Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us.
Visit: Jobs.cancercenter.com to begin your journey.