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Senior
Job Details Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and…
Skills: Scenario modeling, Managed care contract negotiations, Financial analysis, Data aggregation, Reimbursement modeling
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Full-time
bachelor degree, postgraduate degree
Medical insurance, Prescription insurance, Supplemental insurance, Dental insurance, Vision insurance, Life insurance
Posted 10d ago
~40 hrs/week
Responsibilities
The Senior Payer Contract Analyst performs scenario modeling and analytics to support managed care contract negotiations and monitor contract performance. They also ensure compliance with CMS Price Transparency requirements and validate payer rate loads to ensure accurate contract execution.
Requirements
Candidates must have a Bachelor's degree in Finance, Healthcare Administration, or a related field and at least 5 years of experience in payer-related financial analysis. Proficiency in Microsoft Excel, PowerPoint, and contract modeling or BI tools like Qlik, Tableau, or PowerBI is required.
Full job description
Job Details
Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.
Job Description
Schedule: Monday - Friday, 8:00 am - 4:30 pm.
Hybrid: Travel to the location quarterly
Summary Senior Payer Contract Analyst is responsible for performing scenario modeling and analytics to inform managed care contract negotiations, monitor contract performance, and assess impact of industry trends and government regulations. Senior Payer Contract Analyst will retrieve, aggregate, and analyze data from multiple sources, using a variety of tools, to support the functions of the Payer Contracting department. Senior Payer Contract Analyst will collaborate with team members to understand their needs/goals and function as a trusted analytics delivery partner to answer pertinent business questions using all available data assets.
Job Duties
Conduct detailed managed care contract modeling and analysis using available contract modeling systems.
Build flexible models that aggregate fee-for-service and value-based data from multiple sources and enable scenario play.
Maintain key department metrics (e.g. Managed Care Financial Reporting package, payer mix, reimbursement benchmarks) and monitoring tools (e.g.contract and rate tracking grids).
Ensures compliance with all CMS Price Transparency requirements relating to development, accuracy, and publication of machine-readable files.
Monitor payer policy updates and quantify impact of potential material harm and/or other contract implications.
Validate payer rate loads to ensure contracts are being executed accurately and perform root-cause analysis of variances.
Serves as a resource to management to assist in ad-hoc projects.
Minimum Qualifications
Bachelor’s Degree Finance, Healthcare Administration, Business or related field
5 years Experience in payer related position(s) in provider or insurance industry with minimum 5 years experience in budgeting, insurance/payer related financial analysis, net revenue reimbursement modeling and performance computations, decision support, and general financial reporting.
Intermediate to advanced capabilities with Microsoft Excel and PowerPoint
Experience building and manipulating Contract Modeling tools and BI/Data Analytics applications (e.g. Qlik, Tableau, Microsoft PowerBI, EPSi).
Ability to thrive in a fast-paced, agile work environment with high expectations and accountability.
Excellent written and verbal communication skills.
Efficient conceptualization, analytical and logic skills.
Preferred Qualifications
Master’s Degree Finance, Healthcare Administration, Business or related field
Additional Qualifications
Physical Demands Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Thomas Jefferson University Hospitals, Inc.
Primary Location Address
1101 Market, Philadelphia, Pennsylvania, United States of America
Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.
Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.
Jefferson Health Plans provides trusted health insurance plans that prioritize your well-being.
With a commitment to personalized healthcare, accessible health services, and a strong healthcare provider network, we empower individuals and families to take charge of their health. Our mission is to improve the lives of our communities by delivering quality plans with exceptional member service.
What We Offer:
✅ Comprehensive health coverage for all stages of life
✅ Easy access to quality healthcare and top providers
✅ Health and wellness programs to support your journey.
Managed Care OrganizationMedicaidCHIPIndividual and Family PlansHealth Insuranceand Medicare AdvantageConsumerHealth CareLife InsuranceInsurance
How many Finance & Accounting jobs are open in Philadelphia, PA right now?
There are currently 1,311 open finance & accounting positions in Philadelphia, PA listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Finance & Accounting roles in Philadelphia, PA?
Companies currently hiring include H&R Block, Chubb Life Hong Kong, JPMorganChase, PNC, Symmetry Financial Group, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Finance & Accounting jobs in Philadelphia, PA?
Yes — 499 of the 1311 open finance & accounting positions offer remote or hybrid work (185 remote, 314 hybrid).
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