MGR PAYER STRATEGIES ANALYTICS
ID: 7194441 (Ref.No. hlj_50714)
Posted: November 17, 2023
Application Deadline: Open Until Filled
The Manager, Payer Strategy Analytics is responsible for supporting the analytical needs of the Payer Strategies team. This is primarily done through the planning, execution, and upholding of financial analyses for all manner of current and future reimbursement models, including both fee-for-service and alternative payment terms. The Manager will be responsible for hiring and developing a team of analysts who will be able to provide these essential financial analyses to all stakeholders, but may also directly create these assessments as needed.
The Manager will directly participate in negotiations with payer partners, under the direction and guidance of the Director, Managed Care and the Vice President, Payer Strategies, using analytical tools to develop proposals and responses between Moffitt and external parties. The Manager will be a key participant in developing the strategies for Moffitt's reimbursement and payer contracting decisions, using a strong background in healthcare finance, sound principles of accounting and finance, and knowledge gained from performing and reviewing financial analyses.
In addition, the Manager, Payer Strategy Analytics is charged with oversight of Moffitt's overall contract maintenance and modeling function which includes monitoring data upload processes in live and test environments and validating data integrity. This function includes oversight of building models of proposed contracts, as well as monitoring performance of contracts in terms of accurate reimbursement proposals and realization of payment receipt. Accordingly, the Manager will directly supervise the role of Contract Analyst, which is charged with the entry, audit, and maintenance of Moffitt's reimbursement contracts in the Center's financial billing system.
Finally, the Manager will be relied upon to accumulate, validate, and administer the department's data resources which will be the foundation for financial analysis and decision-making. The Manager will act as a liaison to key collaborative departments, internal customers, and external partners.
The Ideal Candidate will have:
- Preferred experience with Soarian Financials
- Preferred experience working with PMMC's "Contract Pro" or "Physican Pro" (C-Pro or P-Pro) tools
- Strong knowledge of SQL and data modeling tools
- Planning, development, and oversight of financial analytics
- Direct participation in Managed Care contract Negotiations
- Participation in development of Moffitt's managed care and reimbursement strategies
- Hire, develop, and manage a team of skilled analysts to support the extensive scope and volume of data needs
- Serve as liaison to key collaborators and stakeholders, both internal and external to Moffitt
- Manage the accumulation, validation, and administration of existing and future data sources needed for effective financial analysis
- Ensure the timely and accurate maintenance of Moffitt's reimbursement contracts in all relevant systems, but particularly in the financial billing system.
Minimum Experience Required:
- Minimum of ten (10) years of healthcare administration and /or decision support experience; inclusive of five (5) years minimum leadership/influencing experience in analytics for new payment models such as bundles, shared savings, population health.
CPA/MBA or MHA * may be considered and will satisfy up to three (3) years of the above experience
Minimum Skills/Specialized Training Required
Due to the high level of interaction with management, clinicians, and administrative staff, and the technical nature of the position, the incumbent should have excellent communication skills and the ability to interact with all levels of management. Person must be analytical and able to react quickly to change. Additionally, must be able to manage and lead external relationships and communicate clearly our financial goals and analytical requirements. Examples of external relationships include consultants, vendors, payers and employers.
Must be able to communicate objectives clearly. Excellent team-building and project management skills. Excellent interpersonal skills are required. Able to critically think and determine appropriate decisions within established frameworks, to problem-solve given a multi-faceted problem. Strong teaching and presentation skills, effective verbal and written communication skills to translate information to all levels in the organization.
The incumbent must have strong foundation of healthcare finance, understanding of common methods of reimbursement, prudent judgment of relevant reimbursement principles for making estimates and validating results, and knowledge of essential components of hospital billing data.
Mission To create a Moﬃtt culture of diversity, equity, and inclusion as we strive to contribute to the prevention and cure of cancer. Vision To advance and accelerate a culture of access, equity, and inclusion. Diversity is a priority at Moffitt and is meant "to promote a culture of diversity and inclusion as we contribute to the prevention and cure of cancer." The Enterprise Equity Department focuses its efforts on eliminating those obstacles to an individual’s ability to exist within their personal comfort zone at the cancer center. Everyone is important to meeting this priority. Addressing and responding to diversity and inclusion fosters an environment where mutual respect for diverse cultures, communication styles, languages, customs, beliefs, values, traditions, experiences and other ways in which we identify ourselves, is the expectation.