Overview:
Ardent Health Services is a leading provider of healthcare in communities across the country. Through its subsidiaries, Ardent owns and operates nearly 200 sites of care and 30 hospitals across six states. Together, our 24,000 employees and 1,200 employed providers touch more than 10,000 lives each day. With six Ardent entities earning recognition on Modern Healthcare’s Best Places to Work list in 2022, Ardent and its facilities continue to earn recognition for outstanding workplace cultures where team members feel a sense of belonging and have opportunities to grow their careers. Ardent has also been recognized by Comparably’s Best Places to Work Awards, earning honors in the Best CEO, Best Company for Women, Best Leadership Teams and Best Work Life Balance categories among others.
We have an exciting opportunity to join our Contract Management team as a Managed Care Pricing & Analytics Modeling Analyst.

POSITION SUMMARY

The Managed Care Pricing & Analytics Modeling Analyst will provide decision support to management for new and or changing reimbursement rates. In coordination with Managed Care, the Contract Modeling Data Analyst will provide modeling scenarios needed during contract negotiations by using both complex data models and a contract modeling system. This position will analyze yields of scenarios and monitor the alignment of billing with contract terms and assist in developing rates and terms within the contract management system to meet targeted increases. Analysis of service lines and cost components is also an integral part of this position.

Responsibilities:

• Conduct financial modeling, analysis and reporting related to managed care contract negotiations
• Concisely summarize and communicate the results of modeling activities in time sensitive environment
• Maintain working knowledge of current Modeling, Data Warehouse and Patient Accounting systems.
• Mine data from multiple sources with multiple criterion and performing detailed analysis to verify the completeness and accuracy of the data and evaluate the data in the context of the designated project.
• Perform review of contracts and monitor financial performance and compliance to negotiated rates to ensure net revenue was realized to aid in preparation of upcoming negotiations.
• Assist with contract negotiation process by analyzing trends in current reimbursement and potential changes needed to have positive impact or improvement to reimbursement.
• Understand details of various reimbursement methodologies common to managed care payers as well as Government payers
• Knowledge of Payer products and product differentials
• Analyze service line information by payer to understand volumes and rate shortfalls compared to costs.
• Prepare ad hoc reports around payer performance.
• Foster relationships with facility/market and corporate personnel to understand market operations and similarities with payer contracts.
• Coordinate with other Contract Management staff for understanding of contract intent when programming rates into the Production contract management system.

Qualifications:

EDUCATION AND EXPERIENCE:

• Bachelor’s Degree required. Accounting, Finance or Business degree preferred.
• 4+ years of analytical experience in financial analysis, health care pricing, network management, health care economics2+ years of experience in creating and using financial modeling tools, spreadsheets or other related systems/tools including experience in interpreting modeling results to inform decisions in negotiations
• Experience working with data integration and self-service data preparation, models, and analytics.
• Should possess experience and judgment to plan and accomplish goals with the ability to prioritize assignments, deal with interruptions and meet deadlines with limited supervision in a fast-paced and growth-oriented environment.
• Experience with BI technologies (Microsoft Power BI, Oracle, BI, Tableau etc.) preferred
• Epic Patient Accounting system, Nthrive Contract Management, and SAP Business Objects experience preferred.

KNOWLEDGE, SKILLS AND ABILITIES:

• Knowledge of Managed Care Contracts and Medicare payment methodologies.
• Intermediate to advanced Proficiency in Microsoft Office and Excel.
• Excellent verbal, written, analytical, and interpersonal skills.
• Knowledge and experience with SQL, including understanding of data warehousing, data mining, and relational database concepts and technologies based on multiple data sources preferred
  

  LI-AM

• Conduct financial modeling, analysis and reporting related to managed care contract negotiations
• Concisely summarize and communicate the results of modeling activities in time sensitive environment
• Maintain working knowledge of current Modeling, Data Warehouse and Patient Accounting systems.
• Mine data from multiple sources with multiple criterion and performing detailed analysis to verify the completeness and accuracy of the data and evaluate the data in the context of the designated project.
• Perform review of contracts and monitor financial performance and compliance to negotiated rates to ensure net revenue was realized to aid in preparation of upcoming negotiations.
• Assist with contract negotiation process by analyzing trends in current reimbursement and potential changes needed to have positive impact or improvement to reimbursement.
• Understand details of various reimbursement methodologies common to managed care payers as well as Government payers
• Knowledge of Payer products and product differentials
• Analyze service line information by payer to understand volumes and rate shortfalls compared to costs.
• Prepare ad hoc reports around payer performance.
• Foster relationships with facility/market and corporate personnel to understand market operations and similarities with payer contracts.
• Coordinate with other Contract Management staff for understanding of contract intent when programming rates into the Production contract management system