Hours: M-F Day

Full Time: 40 hours/week

General Summary

Performs a variety of payment/financial analysis and financial reports for all System entities. Assures payor compliance with contract financial terms. Performs a wide variety of fiscal analysis and contracting recommendations in support of Payor Contracting and Population Health Finance. Provides financial support of contracted payor reimbursement, which include, but are not limited to, financial analysis, payor performance reporting, development of other fiscal management processes to support Payor Contracting and Population Health's portion of System's continuous pursuit of its Mission. Works independently and exercises independent judgment and discretion.

Duties and Responsibilities

Remote Work Capable

Essential Functions:

Prepares and analyzes various data reports in support of payor negotiation for all System entities (Hospitals, Medical Groups, VNA, WellSpan Pharmacy, WME and Apple Hill Surgery Center).Prepares and analyzes the financial impact for specialty services, specialty pricing/bundles, and entities, such as Hospitals, Medical Groups, Ancillaries and Dental Center.Prepares, analyzes, and maintains payor performance reports/yield and payor scoring reports for all System entities and identifies opportunities for improvement.Develops predictive modeling in support of payor negotiation for all System entities.Prepares annual budget forecasting and modeling support for all System entities.Supports System compliance with contract notification terms, such as, annual price increases and changes in service.In conjunction with Vice President of Payor Contracting & Population Health, prepares analysis for unique reimbursement methodologies for specialized payor contracts.Supports professional and collaborative relationships with Payors and team members.Provides ad-hoc financial and negotiation analysis and reports to System management as requested.In conjunction with operational staff, analyzes financial impact of contract reimbursement, policy, or language changes/initiatives.In conjunction with Director of Payor Contracting, assures that proposed, new and/or changed contractual programs are attainable within the organization, the contract language accurately memorializes the agreed upon terms and appropriate WellSpan Health personnel is educated on the new or changed programs.Maintains knowledge of industry accepted contractual arrangements, financial opportunities, operational challenges, and other payor initiatives, including but not limited to State and Federal MCO regulatory programs.Participates in the strategic improvement of payor contracts as part of the Contract Integration Team and at times with Chief Clinical Directors, Directors of Quality, Administrative Vice Presidents, Quality and Clinical Improvement Managers, Ancillary and Hospital Leadership and Payors.Analyzes performance programs such as Arches, Foundations, Restorative Pain Management, Hospital at Home, bundle payment opportunity and any new requests.Validates and reconciles payor reporting, Cost and Utilization reporting, and internal dashboards.Utilizes Behavioral Health and Pharmacy Analytics to support negotiations.Assists with reporting requests for all Deloitte model updates.Performs proactive operational payor reporting - payor policy impacts via financial analytics tools.Supports, updates, and maintains Payor Scorecard.Supports, updates, and maintains Competitive Pricing Tool.

Travel Requirements:

Estimated Amount: 10% - Local and regional travel

Qualifications

Minimum Education:

Associates Degree RequiredBachelors Degree Finance, Accounting, Management and/or Health Care Administration Preferred

Work Experience:

3 years Working knowledge of Health System Revenue Cycle operations and payment methodologies and overall understanding of various aspects of health care financing. Required3 years Healthcare reimbursement, third party payor negotiation/operations or regulatory experience, EPIC reporting, Power BI PreferredAdvanced Excel Skills (Pivot Tables, Advanced Formulas)Must have critical thinking skills.

Courses and Training:

Finance, Data Analysis, Contract Negotiation Upon Hire Required

Knowledge, Skills, and Abilities:

Excellent written and oral communication skills.Interpersonal and computer skills.Analytical, negotiation, and project management skills.Able to work well in a team.Strong Microsoft Excel experience.

NOTE: Must be within 2-3 hours of WellSpan's footprint

Benefits Offered:

Comprehensive health benefitsFlexible spending and health savings accountsRetirement savings planPaid time off (PTO)Short-term disabilityEducation assistanceFinancial education and support, including DailyPayWellness and Wellbeing programsCaregiver support via WellthyChildcare referral service via Wellthy You’re unique and you belong here.

At WellSpan Health, we are committed to treating all applicants fairly and equitably, regardless of their job classification. If you require assistance or accommodation due to a disability, please reach out to us via email at . We will evaluate requests for accommodation on a case-by-case basis. Please note that we will only respond to inquiries related to reasonable accommodation from this email address. Rest assured, all requests for assistance or accommodation are handled confidentially, allowing applicants to share their needs openly and honestly with us.