Senior Contract Analyst - REMOTE

Senior Analyst of Payer Analytics

Discover Vanderbilt University Medical Center:
Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated.

It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Job Summary:

Under the strategic direction of the Manager of Payer Analytics, the Senior Analyst of Payer Analytics will drive payer contracting strategy by performing in-depth contract analytic design, execution, and interpretation. This involves deep dive analytics into payer performance and proposed contract terms to order to make decisions on how to structure payer contracts. This position will participate in the design and interpretation of standard reporting as well as conducting ad-hoc drill downs for specific business issues.

There will be interaction with CEOs and executives across three hospital sites as well as revenue cycle, payer relations, and other leadership teams.

• 20%| Strategy and Insights:
  Work with payer relations team on analytic design, execution, and interpretation. Deliver and present analytics and interpretation to business leaders in a digestible format. Provide perspective on new analytics to support payer reimbursement and performance. Proactively take steps towards automation or use of new technology. Provide thoughtful perspective in meetings with management. Understand Medicare and commercial reimbursement, policies, and regulatory requirements and apply to contract modeling, insights, and new ideas.
  
  Manage customer expectations and relationships and maintain alignment of deliverables with organization analytic needs. Serve as an expert on payer contract financial terms and financial modeling. Design and interpret analytics, lead training, and respond to questions across multiple departments.
• 50%| Contract Maintenance:
  Load, update, and maintain contracts in collaboration with a vendor. Develop and maintain workflows and management processes to ensure there are no errors in contract modeling or loading. Model the effect of fee schedule updates on revenue and percentage of Medicare. Identify, interpret, and make recommendations regarding unclear contract or proposed contract terms.
• 30%| Analytic Support:
  For both payer contract negotiations and monitoring, discuss business needs with customer and influence the design of an analysis and execute based on jointly designed specifications. Analyze data to work with colleagues to generate business insights and roll up data into a digestible format. Ability to use data extract and BI tools such as SQL and Tableau/PowerBI. Work with manager to efficiently merge data from multiple databases and find efficient ways to complete reporting.

• Minimum of bachelor's degree in Business, Healthcare, Computer Science or related field.
• Master's degree in Business Administration or comparable field of study preferred.
• 3 or more years' experience in a managed care/healthcare environment with exposure to contract management and program development
• EPIC experience
• EPIC Hospital and Professional contract certification
• Technical ability in ETL and visualization tools such as Tableau, PowerBI, and SQL
• Knowledge of claims processing systems and guidelines Experience with reimbursement methodologies for Medicare and commercial insurance; and regulatory requirements concerning payer contracts
• Ability to produce analytics that are well-documented and easy to follow
• Analytical skills with the ability to collect, organize, analyze, and disseminate information with attention to detail and accuracy
• Strong written and verbal presentation skills including the ability to translate information to a variety of audiences
• Ability to build strong relationships with internal and external stakeholders
• Ability to be flexible and adapt in order to achieve initiative and organizational goals

This role offers the opportunity to make a meaningful impact within Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement and/or wellness offerings to enhance your well-being and professional growth.

Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled.