Analyst, Payor Contracting

at  Summit Health CityMD

About Our Company
We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.
Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients’ homes and virtually through VillageMD and our operating companies
Village Medical
,
Village Medical at Home
,
Summit Health
,
CityMD
, and
Starling Physicians
.
When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.
Job Description
Integral to our team, the Payor Contracting Analyst will be responsible for building and managing the financial reimbursement and analysis of fee-for-service (FFS) contracts with private payers; various ad hoc requests and work in conjunction with other internal VillageMD to improve contract performance. In addition, this individual will assist with post-execution of payer contract activities, including facilitating contract and rate load, fee-for-service schedules, reimbursement structures, document archiving and storage, etc.

How you can make a difference

• Prepare, coordinate, and maintain fee-for-service Fee Schedules, analytical models and reimbursement structures.
• Develop and build models to help VillageMD identify areas to improve revenue.
• Get up to speed on our model and make recommendations for changes to improve the accuracy and efficiency of the process.
• Assist in operational and financial support of implementation of VMD’s Payor Contracting business plan, achievement of operating results, and strategic priorities.
• Provide insights to help negotiators utilize various contract methodologies, actuarial approaches, and financial strategies to optimize the value of payor agreements.
• Maintain strong interpersonal relationships within VillageMD departments, including Revenue Cycle, and Finance.

Skills for success

• Ability to be proactive with strong personal initiative as well as highly organized and detail oriented.
• Understanding of reimbursement models, CPT/HCPC codes, Medicare, Medicaid and Commercial Managed Care Payors.
• Excellent verbal and written communication skills; ability to convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others, including but not limited to reimbursement policy standards.
• Strong interpersonal skills, establishing rapport and working well with others.
• The ability to handle multiple, concurrent projects.
• Challenging the status quo to improve our processes and tools.
• Knowledge and understanding of health plan network operations preferred.

Experience to drive change

• Experience in Healthcare.
• Payor and/or Provider contracting experience preferred.
• Understanding of provider revenue cycle, and/or fee-for service contract load and testing
• Experience in healthcare finance, including contracting methodology and modeling preferred.
• Demonstrated analytical, project management, and leadership skills.
• Knowledge of contract methodologies and preferred financial and administrative terms
• Ability to think independently and develop new processes/analyses required.
• Strong organizational skills with the ability to multi-task and execute against multiple competing priorities.
• Proficiency in Excel, PowerPoint, and Word required.

For Colorado Residents only: This is an exempt position. The base compensation range for this role is $60,000 to $80,000. At VillageMD, compensation is based on several factors including but not limited to education, work experience, certifications, location, etc. The selected candidate will be eligible for a valuable company benefits plan, including health insurance, dental insurance, life insurance, and access to a 401k plan.
About Our Commitment
Total Rewards at VillageMD
Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.
Equal Opportunity Employer
Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.
Safety Disclaimer
Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit,
https://www.consumer.ftc.gov/JobScams
or file a complaint at
https://www.ftccomplaintassistant.gov/

Please refer the Job description for details