• Conduct extremely complex and diverse analytical financial, utilization-focused, statistical, operational and cost/benefit projects in order to assist leadership with budget projections, provider contract performance determinations, internalization analytics and to develop a regional contracting strategy.
• Design and develop data analyses and reports that will track contract performance and forecast the impact of rate modifications and medical cost performance. These results will improve contract compliance, prospective contract terms and rates; and help to identify clinical practice patterns that positively or negatively affect costs.
• Work with the national program office to develop national reporting and benchmarking initiatives; and other strategic work related to hospital network development. Analytical, contract modeling and financial reporting support for other regions will also be required.
• Interfaces with Medical Directors and other regional executives to devise medical cost initiatives, drive cost improvement, and assist in developing the organization’s annual medical expense budget.
• Train other employees in modeling techniques and contract modeling system functions.
• Minimum five (5) years experience in a managed care/healthcare organization required.
• Minimum five (5) years academic or relevant work experience to strongly demonstrate the following skills and knowledge: Data analysis, statistical analysis, communication skills, analytical skills, interpersonal skills and group facilitation skills.
• Minimum five (5) years experience in financial, resource management or executive level reporting.
Education
• Bachelors degree from an accredited university/college in the fields of economics, math, finance, health care management or four (4) years directly related experience.
• High School Diploma OR General Education Development (GED) required.
Additional Requirements:
• Must have in-depth familiarity with corporate data environment/data warehouse structure. Use of relational databases and end-user tools (e.g. SQL) to develop interfaces that support senior leadership information requirements.
• Proficient in Microsoft Office Products, Access, Cognos, Paradox or similar database, and query writing.
• Experience in managing multiple requests.
Preferred Qualifications:
• Demonstrated leadership ability, particularly as a collaborator and strong partner in shared leadership roles preferred.
• Strong background and familiarity with the use and interpretation of quantitative reports and analysis; strong evidence of sound analytical skills preferred.
• Demonstrated ability to determine the key business issues and to develop appropriate action plans from multi-disciplinary perspectives preferred.
• Understanding of the fundamentals and dynamics of a group-practice and a health maintenance organization preferred.
• Knowledge of health care operations including primary care, specialty and ancillary services preferred.
• Knowledge and functional experience with contract management/modeling systems preferred.
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