Boston Children's Hospital
Financial Analyst II for Payor Contracting (Remote)
Boston Children's Hospital, Boston, Massachusetts, us, 02298
At Boston Children's Hospital, the quality of our care - and our inclusive hospital working environment - lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included.The Financial Analyst II for Payor Contracting (Remote) helps manage the ongoing review of actual payor payments versus expected payments through the process of routine retrospective auditing of payments. Responsible for data mining and performing managed care contract analyses for various clients on a regular basis, including summarizing financial trends and impacts for Hospital, Physicians' Organization, and Pediatric Physicians' Organization at Children's Hospital (PPOC). Aides in the development of auditing schedules, tracking mechanisms and coordinating the pursuit of the recovery of net revenue, rebilling of claims and/or settlement opportunities.This Financial Analyst II for Payor Contracting will be responsible to:
Design and build financial models to support various reporting and contracting needs, including payer contract negotiations on behalf of the Hospital, Physicians' Organization, Pediatric Physicians' Organization at Children's Hospital (PPOC), and Boston Children's Health Physicians (BCHP).Develop methodologies and leverage internal reporting systems to gather and compile the required data. Employ significant understanding of Hospital/physician contractual reimbursement methodologies and non-fee-for-service arrangements.Prepare appropriate analyses for review by various committees and senior leadership. Make recommendations regarding contract terms and fees.Perform detailed analyses of various commercial and governmental contract performance, including patient detail account transaction activity review for payment collection accuracy.Maintain and update the Managed Contract System based on commercial and governmental contracts. Perform system set up and testing as necessary to ensure contracts are accurately configured and modeled.Assist Analyst I in compiling quarterly and annual Hospital/physician fee schedules by payer contracts.Create, organize, and maintain files using database and spreadsheet programs; compile data into required reporting formats, including Excel and PowerPoint presentations.To qualify, you must have:A Bachelor's degree is required, preferably in Business/Finance/Economics or a closely related field, and at least 2-3 years of related experience in financial analysis, preferably in a Healthcare setting.Understanding of payer contracts and documents relevant to healthcare reimbursement.Skilled at identifying trends and understanding content within data.Possesses some knowledge of ICD-10, CPT and HCPCS codes, Medicare RVU, and DRG coding methodologies.Insight into contracting reporting systems and data output, with the ability to identify opportunities for enhanced practices.Strong technical skills and proficiency with MS Office applications, especially Excel.This position is 100% remote, with opportunity for flexible work schedule.Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.Boston Children's Hospital requires all employees to be vaccinated against COVID-19 and Flu, (unless you are eligible for a medical or religious exemption).Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
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Design and build financial models to support various reporting and contracting needs, including payer contract negotiations on behalf of the Hospital, Physicians' Organization, Pediatric Physicians' Organization at Children's Hospital (PPOC), and Boston Children's Health Physicians (BCHP).Develop methodologies and leverage internal reporting systems to gather and compile the required data. Employ significant understanding of Hospital/physician contractual reimbursement methodologies and non-fee-for-service arrangements.Prepare appropriate analyses for review by various committees and senior leadership. Make recommendations regarding contract terms and fees.Perform detailed analyses of various commercial and governmental contract performance, including patient detail account transaction activity review for payment collection accuracy.Maintain and update the Managed Contract System based on commercial and governmental contracts. Perform system set up and testing as necessary to ensure contracts are accurately configured and modeled.Assist Analyst I in compiling quarterly and annual Hospital/physician fee schedules by payer contracts.Create, organize, and maintain files using database and spreadsheet programs; compile data into required reporting formats, including Excel and PowerPoint presentations.To qualify, you must have:A Bachelor's degree is required, preferably in Business/Finance/Economics or a closely related field, and at least 2-3 years of related experience in financial analysis, preferably in a Healthcare setting.Understanding of payer contracts and documents relevant to healthcare reimbursement.Skilled at identifying trends and understanding content within data.Possesses some knowledge of ICD-10, CPT and HCPCS codes, Medicare RVU, and DRG coding methodologies.Insight into contracting reporting systems and data output, with the ability to identify opportunities for enhanced practices.Strong technical skills and proficiency with MS Office applications, especially Excel.This position is 100% remote, with opportunity for flexible work schedule.Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.Boston Children's Hospital requires all employees to be vaccinated against COVID-19 and Flu, (unless you are eligible for a medical or religious exemption).Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
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