Hospital for Special Surgery Analyst - Payor Strategy in New York, New York
Payor Strategy and Contracting
The Analyst in the Payor Strategy and Contracting department will provide analytic support to both the Payment Reform and Managed Care subdivisions of the department.
Bachelor’s Degree (Masters preferred)
Advanced experience with APR-DRG, MS-DRG, Ambulatory Surgery Center groupers, APC, APG, and RBRVS reimbursement methodologies
A comprehensive understanding of current episode payment methods used by CMS and by commercial payers, in addition to other complex reimbursement methodologies
Knowledge of hospital operations, health/insurance benefit plans, and revenue cycle claims systems
Attention to detail and the ability to spot errors and inconsistencies
Strong communication and organizational skills
Proficiency in Word, PowerPoint, PowerPivot, and Excel
Previous experience in managed care and/or episode-based payment methodologies highly desirable
Coordinate, compile, model and analyze the financial/cost impact of new and existing value based care provider contracts including global payment and risk-sharing arrangements, utilizing complex spreadsheet and/or database applications.
Work collaboratively with finance staff in support of on-going trend analysis by identifying and analyzing drivers of change in unit cost and the impact of unit cost on medical cost trends by category of care and by service line.
Monitor contract financial performance and develop managed care performance reports
Develop service line and physician level reimbursement analyses and models (involving multiple variables and assumptions) to support a variety of new/revised strategies, approaches, and provisions.
Identify, compile and analyze financial information from all internal and external financial and clinical databases/sources to support analyses. Perform sensitivity analyses and identify risk/exposure associated with operational changes. Develops integrated analyses, projections, routine reports, and presentations to reflect actual performance trends.
Maintain knowledge of operations sufficient to identify causative factors, deviations, allowances that may affect report findings.
Provide general decision support for entire Payor Strategy and Contracting team by utilizing Strata, Epic, etc. for reporting requests.
Prepare and effectively present results to senior leadership, and other key stakeholders, for review and decision making activities.
Hours per Week: 35
External Company Name: Hospital for Special Surgery
External Company URL: www.hss.edu
Street: 535 E 70th St