Ovation Healthcare
Ovation Healthcare is the premier provider of shared services to improve hospital and system performance.
Analyst, Payer Relations
Location
Tennessee
Posted
30 days ago
Salary
Not specified
Bachelor DegreeEnglish
Job Description
• Collect and validate data from hospitals for modeling, analytics, and presentation.
• Evaluate existing and proposed payer contracts to determine financial feasibility and impact on the organization’s bottom line.
• Model Portal – Maintain all request for all hospital models and maintain tracker
• Analyze and interpret complex managed care contract proposals, including reimbursement methodologies, and load or update contract terms in the designated contract management system.
• Manage data validation for all databases.
• Audit and monitor claim payments from managed care plans to ensure accurate reimbursement according to contract terms.
• Investigate payment variances and discrepancies, identifying root causes for underpayments.
• Assist with data analysis and create tables and forms for Presentation.
• Monitor and manage assigned deadlines for models. Including tracker maintenance and internal communication with consultants
• Assist with regular/ad hoc reporting requests, dashboards for management on payer mix, financial performance, and compliance metrics.
• Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems.
• Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations.
• Graphically/analytically strong; excellent analytical, critical thinking, and problem-solving skills, with meticulous attention to detail.
• Strong communication skills to effectively present complex data to both technical and non-technical stakeholders.
• Track and report on Key Performance Indicators (KPIs)
• Assist with validating financial analysis prior to presenting to hospital or payers
• Maintain and organize client information
• Assist leadership with annual team goals
Job Requirements
- Minimal travel
- Understanding of managed care contracting and related initiatives are useful but not required as well as the underlying systems that support those initiatives.
- Understanding of Revenue Cycle process is useful but not required.
- BS Preferred
- Advanced knowledge of Microsoft products Excel (VLOOKUPS, Pivot tables, data modeling)
- Familiar with Microsoft Power Point / Power BI
- Experience with Electronic Health Records (EHR) and Billing Systems (i.e. Epic, Cerner) preferred
- Ability to interact with clients and strong communication skills
- Team player
- Organizational skills / multitasking
- Data analysis experience critical
- Critical thinker
- Problem solving skills
- Ability to work in a fast-paced environment independently
Benefits
- Health insurance
- Professional development opportunities